<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 26-year-old man presents to the emergency room with a complaint of lower abdominal pain that started about 5 hours ago. The pain was initially located around the umbilicus but later shifted to the right lower abdomen. It is a continuous dull, aching pain that does not radiate. He rates the severity of his pain as 710. He denies any previous history of similar symptoms. The vital signs include heart rate 100min, respiratory rate 20min, temperature 38.0C 100.4F, and blood pressure 11477 mm Hg. On physical examination, there is severe right lower quadrant tenderness on palpation. Deep palpation of the left lower quadrant produces pain in the right lower quadrant. Rebound tenderness is present. The decision is made to place the patient on antibiotics and defer surgery. Two days later, his abdominal pain has worsened. Urgent computed tomography CT scan reveals new hepatic abscesses. The complete blood count result is given below:Hemoglobin 16.2 mgdLHematocrit 48Leukocyte count 15,000mm3Neutrophils 69Bands 3Eosinophils 1Basophils 0Lymphocytes 24Monocytes 3Platelet count 380,000mm3Which of the following complications has this patient most likely experienced?? A: Pylephlebitis, B: Intestinal obstruction, C: Peritonitis, D: Perforation, E: Appendiceal abscess,  <response>: Based on the information provided in the question stem, this 26-year-old man initially presented with symptoms consistent with appendicitis, including right lower quadrant abdominal pain that began periumbilically and later localized to the right lower quadrant. He was treated with antibiotics but two days later his pain worsened and a CT scan showed new hepatic abscesses. His lab results show a markedly elevated white blood cell count with a left shift, indicating infectioninflammation. The development of hepatic abscesses indicates that his appendicitis has progressed to a complication. The most likely complication in this scenario is pylephlebitis, which is inflammation of the portal vein caused by spread of infection from the inflamed appendix. Pylephlebitis can lead to septic thrombophlebitis of the portal vein and liver abscesses. Intestinal obstruction, perforation, and peritonitis are other potential complications of appendicitis but do not explain the hepatic abscesses in this case. An appendiceal abscess would not directly cause liver abscesses. Therefore, pylephlebitis is the most likely diagnosis.A: Pylephlebitis 