Here is the paraphrased version of question 109 with five options, including the correct answer and explanation:
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**Question:**
A 58-year-old man was initially treated conservatively with antibiotics for appendicitis. He now presents with an appendicular mass but no evidence of a collection on imaging. What is the most appropriate next step in management?
**Options:**
A) Immediate laparoscopic appendectomy
B) Interval laparoscopic appendectomy after 12 weeks
C) No further intervention needed
D) Colonoscopy after 6 weeks
E) Repeat imaging in 4 weeks
**Correct Answer:** D) Colonoscopy after 6 weeks
**Explanation:** In the presence of an appendicular mass without an abscess or collection, it is important to rule out other potential causes, such as malignancy. **Colonoscopy after 6 weeks** is recommended to evaluate the colon and ensure there are no underlying pathologies, such as a neoplasm, that might have been missed during the acute phase of appendicitis.
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