Afghanistan Comprehensive Specialization Exam

Practice session

A 24-year-old previously healthy male presents with a 24-hour history of periumbilical pain that migrated to the right lower quadrant, associated with anorexia, low-grade fever (38.0 C), and nausea. Physical examination demonstrates tenderness at McBurney's point with guarding and positive Rovsing and obturator signs. Laboratory evaluation reveals leukocytosis (14,500/uL with 82% neutrophils). An ultrasound demonstrates a non-compressible, blind-ending tubular structure in the right iliac fossa measuring 8.5 mm in outer diameter with a hypervascular wall and a calcified appendicolith. What is the standard, definitive management for this early uncomplicated presentation?

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