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Discussion Starter · #1 ·
A 64-year-old woman presents with left lower quadrant abdominal pain and constipation. On physical examination, her temperature is 38.3°C and a tender left lower quadrant abdominal mass is palpable.
Laboratory studies include a normal abdominal radiograph and a complete blood cell count (CBC) showing a leukocyte count of 15.0・~109/L with a left shift.​

What should you do next?

a. Obtain stool cultures and blood cultures and perform flexible sigmoidoscopy.
b. Obtain stool cultures and schedule a return visit in 2 days for review of the culture report.
c. Obtain stool cultures, begin oral antibiotic therapy, and instruct the patient to schedule
a return appointment if her symptoms do not improve.
d. Admit her to the hospital, give her nothing by mouth, administer IV fluids and antibiotics, and obtain a surgical consultation.
e. Recommend emergency surgery.​

· Registered
137 Posts
This patient seems to have diverticulitis.

The answer would be C.

The point is that we should not do sigmoidoscopy in this case as it can result in the perforation of the diverticulated sigmoid colon.

Antibiotics will do a good job
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