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Acute appendicitis — MCCQE Part 1 MCQ

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ModerateAbdominal PainAcute appendicitisMCCQE Part 1

A 72-year-old woman has RLQ pain, fever, leukocytosis. CT: thickened appendix 12mm with periappendiceal fat stranding and appendicolith. No perforation or abscess. Most appropriate management?

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Correct answer: B — Laparoscopic appendicectomy within 24 hours

Acute appendicitis: lap appendicectomy within 24 hours standard of care. In elderly, higher malignancy risk. Appendicolith increases failure rate of conservative management. Colonoscopy 4-6 weeks post-op for patients >40.

Reference: Canadian Association of General Surgeons