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Acute appendicitis — MCCQE Part 1 MCQ

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EasyAbdominal PainAcute appendicitisMCCQE Part 1

A 21-year-old man presents with 12 hours of abdominal pain that began near the umbilicus and migrated to the right lower quadrant. Temperature is 38.1°C, WBC is 14 x 10^9/L, and he has rebound tenderness at McBurney point. What is the most likely diagnosis?

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Correct answer: E — Acute appendicitis

Migratory periumbilical-to-right-lower-quadrant pain with fever, leukocytosis, and localized peritonism is classic for acute appendicitis. Ureteric colic usually causes flank-to-groin pain with haematuria. Mesenteric adenitis and gastroenteritis usually lack focal peritonism. Crohn disease can mimic appendicitis but the acute migratory pattern and rebound make appendicitis most likely.

Reference: Canadian Association of General Surgeons acute appendicitis resources