Facharzt FMH Chirurgie Practice Questions - Facharzt FMH Für Chirurgie Spécialiste FMH En Chirurgie Exam

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A 24-year-old previously healthy male presents to the emergency department with a 14-hour history of periumbilical pain that has migrated to the right lower quadrant. He reports anorexia, low-grade fever (38.1°C), and localized tenderness with guarding at McBurney's point (Alvarado score 8). Laboratory tests show a white blood cell count of 14.5 × 10^9/L with 82% neutrophils and a CRP of 38 mg/L. Abdominal ultrasound demonstrates a non-compressible, blind-ending tubular structure in the right iliac fossa measuring 8.5 mm in outer diameter with surrounding hyperechoic fat stranding. What is the standard evidence-based management of choice?

Laparoscopic appendectomy within 24 hours of admission Immediate right hemicolectomy with primary ileocolic anastomosis Outpatient oral ciprofloxacin and metronidazole without hospital admission Strict nonoperative management with high-dose intravenous corticosteroids

Correct Answer:

Laparoscopic appendectomy within 24 hours of admission

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