13. The correct answer is B. The sensitivity of CT scan for appendicitis is not 100%. The standard of care is observation under general surgery in this age group. The child does have some white blood cells in his urine but no bacteria. This is not usual in appendicitis because of the close proximity of the ureter to the appendix. When the appendix is inflamed it can cause dumping of WBC in the urine because of the inflammation caused to the ureter. Children in this age group with constipation do not have voluntary guarding. This patient does not need a testicular ultrasound because he has no evidence of torsion.
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