A 21-year-old man presents with 12 hours of periumbilical pain migrating to the right iliac fossa, anorexia, low-grade fever and localised tenderness ...

Question

A 21-year-old man presents with 12 hours of periumbilical pain migrating to the right iliac fossa, anorexia, low-grade fever and localised tenderness with guarding. WCC is mildly elevated. Ultrasound is suggestive of acute appendicitis. What is the most appropriate next step?

Accepted Answer

Arrange early surgical review for appendicectomy

Answer

Observe for 24-48 hours and discharge if symptoms settle

Answer

Commence broad-spectrum antibiotics and discharge on oral therapy

Answer

Arrange CT abdomen with contrast as first-line investigation in all

Answer

Reassure and treat with simple analgesia only

au-amc MCQ (SBA): Acute appendicitis

A 21-year-old man presents with 12 hours of periumbilical pain migrating to the right iliac fossa, anorexia, low-grade fever and localised tenderness with guarding. WCC is mildly elevated. Ultrasound is suggestive of acute appendicitis. What is the most appropriate next step?