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A 12-year-old boy presents complaining of abdominal pain. He states that the pain started 12 hours ago and woke him up from sleep. He later developed nausea and vomiting. He denies any blood in his vomit or stool. He has been having normal bowel movements. On exam he has a temperature of 37.9°C (100.3°F), heart rate (HR) 101 beats/min, blood pressure (BP) 120/80, and pain on palpation of his periumbilical region and right lower quadrant. Intravenous (IV) access is gained and labs are sent. What is the next step in his workup?
A. Abdominal computed tomography (CT) scan
B. Air contrast enema
C. Complete blood count (CBC)
D. Surgery consult
E. Testicular ultrasound

The diagnosis of appendicitis is clinical, if the symptoms are typical , we can proced with choice D.

If atypical presentation , do CT.

In this case, D is answer.

aaaaa???/ i will go first ct before surgery becoz they are not telling about murphy sign