robin082006
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A 56-year-old man is admitted with left lower quadrant abdominal pain, fever and an elevated WBC. He said that he has had this pain for the last 48 hours but it became unbearable. He took a few laxatives but did not get better. He says he is a meat eater and hardly eats any vegetables. He does not have regular bowel movements and has been constipating for a few weeks. On examination, his vitals are stable but he does have a low-grade fever. He is tender to palpation in the left lower quadrant, with some guarding. Rectal exam is negative. His WBC is 16,400/cmm. He is admitted and started on IV antibiotics. Forty-eight hours later, the symptoms persist and he has not improved in spite of antibiotic therapy. The diagnostic evaluation most helpful in this setting is:
A. Abdominal x-rays
B. Flexible sigmoidoscopy
C. Colonoscopy
D. CT scan
E. Barium enema
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| Aashi
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D------>CT Scan of the abdomen
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| ts97
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C
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| star1
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Agree with Aashi
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| webjeee
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why not b? sigmoid colon cancer.
Robin, what's the answer?
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| robin082006
Forum Hero
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Answer is D
This is acute diverticulitis.
Do not use colonoscopy due to risk of perforation.
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| webjeee
Forum Guru
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thank you robin, i got it.
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