A 25-year-old woman presents with central abdominal pain that migrated to the right iliac fossa over 12 hours, fever (38.2°C), and nausea. Examination shows point tenderness at McBurney's point, positive Rovsing's sign, and guarding. WBC is 15,000/mm3. The Alvarado score is 8. What is the next best step?

• A CT abdomen and pelvis
• B Laparoscopic appendicectomy ✓
• C Antibiotics and 24-hour observation
• D Ultrasound abdomen

Explanation

An Alvarado score of 7-10 indicates a high probability of acute appendicitis and warrants prompt surgical intervention. Laparoscopic appendicectomy is preferred over open surgery for its lower wound complication rate, faster recovery, and better diagnostic accuracy (especially in women of reproductive age where gynaecological pathology must be excluded). CT is useful when the diagnosis is unclear (Alvarado 4-6). Antibiotics alone can be considered in uncomplicated appendicitis but surgical treatment remains the standard.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.