Guarding in Surgery — Case | General Surgery | SMLE Q#943
SMLE Question #943
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 27-year-old obese woman has 24 hours of worsening right iliac fossa pain that began as vague periumbilical discomfort and then localized. She has anorexia, nausea, and two episodes of non-bilious vomiting. Abdominal examination shows right iliac fossa tenderness with guarding and mild rebound; Rovsing sign is positive. Pelvic examination is unremarkable and pregnancy test is negative. She is hemodynamically stable. What is the most appropriate next step in management?
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