About medicine, seek answers.

This is definitely not a clinical practitioner's problem. It may be a local anatomy teacher who is a little stubborn and very different from clinic. But as a teacher, it is not good to ask questions carefully enough.

The test sites should be omental sac, omental foramen, internal and external organs of peritoneum, left and right mesenteric sinuses separated by mesenteric root and right paracolic sulcus. Classic terrier, you just need to search for "perforated omental sac in the posterior wall of stomach".

It must be a disease of the digestive system, especially the stomach and duodenum. Cover it with a big hat. It's called peptic ulcer.

Ulcer of duodenal bulb and gastric posterior wall often manifests as back radiation pain, and the contents flow into omental sac, accumulate to a certain extent, and then flow out from omental hole into abdominal cavity. When it flows into the right paracolic sulcus, it appears "metastatic right lower abdominal pain" similar to appendicitis, and this kind of perforation sometimes has no obvious pneumoperitoneum.

The descending and horizontal segments of the duodenum are outside the peritoneum, and the posterior wall is perforated and flows to the retroperitoneum. (At that time, there were histological problems. Generally, the digestive tract was a four-layer structure, including mucosa, submucosa, muscularis and serosa. Only the descending and horizontal segments of esophagus and duodenum had three layers, because they were extraperitoneal. In theory, it is also possible to "transfer the pain in the right lower abdomen", but there should be no tenderness and rebound pain.

The anterior wall of descending duodenum is perforated, and the contents flow into the right mesenteric sinus, which is also metastatic right lower abdominal pain, but there should be obvious pneumoperitoneum, and the course of disease will not be as slow as that of flowing into the omental sac, that is to say, it will not transfer for two days.

Cholecystitis and gallbladder rupture will also have similar metastatic right lower abdominal pain, but it is certain that there will be obvious peritonitis in the upper abdomen, instead of tenderness and rebound pain in the upper abdomen described in this question, and the right lower abdomen is the main one. This is also a differential diagnosis, plus appendicitis is two, you can write a first trip. Other radiation pain in the back is pancreatitis, but there is no "metastatic right lower abdominal pain", which is not considered in this case.

I won't answer those questions one by one, which is not very good. The fourth question is a joke.