What is the best next step in management for a patient with suspected appendicitis?

In cases of suspected appendicitis, the next step in management is to confirm the diagnosis before proceeding with invasive treatments such as surgery. In females of childbearing age, performing a pregnancy test is essential because ectopic pregnancy or other gynecological conditions can present with similar abdominal symptoms. Determining whether the patient is pregnant helps to avoid unnecessary surgery in cases where another diagnosis might be responsible for the symptoms.

If the pregnancy test is positive, an evaluation for ectopic pregnancy or another pregnancy-related condition becomes critical. This helps in tailoring the management plan appropriately to the individual’s needs.

While immediate surgery may be a valid management option if appendicitis is confirmed, diagnostic clarity is crucial before decision-making. Similarly, administering antibiotics is not the sole treatment for suspected appendicitis without a confirmed diagnosis. An ultrasound may be useful in certain scenarios, especially to evaluate for gynecological issues, but it does not provide the immediate diagnosis needed to guide urgent treatment decisions. Thus, performing a pregnancy test is a key initial step in the correct management pathway for a patient presenting with these symptoms.