A young male with classic findings (RIF tenderness, guarding, rebound, fever, WBC 15,000) has a high likelihood of appendicitis, so he should go straight to the OR for appendectomy. Imaging adds little when the picture is typical; a CT here would be superfluous and could even mislead if it were negative. Observation without treatment, or discharge on oral antibiotics, delays the definitive treatment and risks perforation.