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Appendicitis in pregnancy — RCPSC EM MCQ

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ModerateGI/Abdominal emergenciesAppendicitis in pregnancyRCPSC EM

A 27-year-old at 18 weeks' gestation has migratory right lower quadrant pain, fever, and vomiting. WBC is 15 x 10^9/L and urinalysis is negative. Ultrasound does not visualise the appendix and shows no ovarian pathology. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — MRI abdomen and pelvis if available

MRI abdomen and pelvis if available is correct: the clues indicate Appendicitis in pregnancy and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian emergency surgery and pregnancy imaging practice