Question of the Week

For December 6, 2022

A 65-year-old man presents for evaluation of left-sided abdominal pain that began 24 hours ago, accompanied by nausea and persistent vomiting. He recalls no prior episodes.

On examination, his temperature is 40°C, and his heart rate is 105 beats per minute. He is tender to abdominal palpation in the lower left quadrant, with some guarding and rebound.

CT of the abdomen shows the presence of diverticula and inflammation of the pericolic fat surrounding the sigmoid colon.

What is the most appropriate next step in managing this patient’s care?

Colonoscopy
Sigmoid colectomy
Oral antibiotic therapy
CT-guided drain placement
Intravenous antibiotic therapy

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