Afghanistan Medical Exit Exam

Practice session

A 21-year-old male presents with periumbilical abdominal pain that began 14 hours ago and has now localized to the right lower quadrant. He has anorexia, nausea, and low-grade fever (38.0°C). On examination, there is marked tenderness at McBurney point with localized guarding and rebound tenderness. Rovsing sign and Psoas sign are positive. Leukocyte count is 14,800/mm3 with 82% neutrophils. What is the most definitive management?

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