Increased abdominal girth that is hard to the touch indicates peritonitis and/or bowel perforation, which is a surgical emergency. Abdominal pain accompanied by fever indicates an abscess or fistula formation, which must be dealt with quickly but is not a surgical emergency without signs of peritonitis or perforation. Pale mucous membranes and severe fatigue indicate anemia, which is an expected finding in the patient with colon cancer and can be treated with blood transfusions. Hyperactive bowel sounds in the upper right quadrant indicate an impending bowel obstruction; it will become a surgical emergency but a board-like abdomen is already a surgical emergency.