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Abscess after appendectomy — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Abscess after appendectomyUSMLE Step 3

A 21-year-old man returns 7 days after laparoscopic appendectomy for perforated appendicitis. He has fever, anorexia, and right lower quadrant pain. CT shows a 5-cm rim-enhancing pelvic fluid collection. Which of the following is the most appropriate next step in management?

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Correct answer: D — Percutaneous drainage plus antibiotics

A postoperative intra-abdominal abscess larger than a few centimeters generally requires source control with drainage plus antibiotics.

Reference: Surgical Infection Society Intra-abdominal Infection Guidance