Ivonne
Forum Guru
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A previously healthy 68 yo M comes to the ER for abdominal pain for 48 hours. T: 38.6 C( 101.5F), HR: 110, RR : 16. Abdominal examination shows left lower abdominal pain tenderness with no peritoneal signs. Rectal examination shows no abnormalities. test for occult blood is negative. WBC: 14 700. Which of the following is the next best step in management:
a.-Barium enema
b.-CT of the abdomen
c.-Colonoscopy
d.-Cystoscopy
e.-Exploratory laparotomy
Pz explain your answer
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| Aashi
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B-------------------->CT Abdomen
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| brutus25
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B - CT of the abdomen - because the inflammation is mostly extraluminal you`re not going to see much with contrast enemas
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| drshvetasm
Forum Elite
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B. Coz all luminal intervention like colonoscopy/sigmoidoscopy r contraindicated in the acute inflammatory diverticulitis. barium is of no use in the acute state,most cases subside with conservative management...so no exploratory laparotomy....
hmmm...what else is left??? cystoscopy...i think u can reason tht out anyway...
Ct is the best modality...to look for development of abcess or to look for perforation in cases where the person isnt responding to conservative management.
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| Ivonne
Forum Guru
Topics: 55
Posts: 1,450
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I know it is a very basic question and i picked CT too but I just wanted to point out that the answers given in the downloaded form are not reliable at all. They think it is C (are you kidding me  )
Thanks all
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