question: Q:A 14-year-old boy is brought to the emergency department because of abdominal swelling and vomiting over the past 24 hours. He has generalized abdominal pain. He has no history of any serious illnesses and takes no medications. His temperature is 36.7°C (98.1°F), blood pressure is 115/70 mm/Hg, pulse is 88/min, and respirations are 16/min. Abdominal examination shows diffuse swelling with active bowel sounds. Mild generalized tenderness without guarding or rebound is noted. His leukocyte count is 8,000/mm3. An X-ray of the abdomen is shown. Intravenous fluids have been initiated. Which of the following is the most appropriate next step in management?? 
  {'A': 'Close observation', 'B': 'Colectomy', 'C': 'Endoscopy', 'D': 'IV antibiotics', 'E': 'Rectal tube'},