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Post-appendectomy intra-abdominal abscess — USMLE Step 3 MCQ

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HardSurgery (post-operative, follow-up)Post-appendectomy intra-abdominal abscessUSMLE Step 3

A 45-year-old man has fever and right upper quadrant pain 5 days after laparoscopic appendectomy. Temperature is 38.8 C, heart rate is 108/min, and WBC count is 17,500/microL. CT abdomen shows a 5-cm rim-enhancing abscess near the cecum without diffuse peritonitis. Which of the following is the most likely diagnosis?

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Correct answer: D — Postoperative intra-abdominal abscess

Fever, leukocytosis, localized abdominal pain, and rim-enhancing collection several days after abdominal surgery indicate a postoperative abscess, usually requiring antibiotics and image-guided drainage if accessible.

Reference: ACS/SHEA/SAGES surgical guidance