What's in Her Pocket: Worsening Diverticulitis

• Published in: The American journal of medicine Vol. 126; no. 7; pp. 581 - 582
• Main Author: Bleich, Lauren M., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2013; Elsevier Sequoia S.A
• Subjects: Clinical outcomes; Colon; Diverticulitis - etiology; Diverticulum - complications; Endoscopy; Female; Foreign Bodies - complications; Foreign Bodies - diagnosis; Gastroenterology; Humans; Internal Medicine; Medical treatment; Middle Aged; Tomography, X-Ray Computed
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2013.03.012

Contrast concealed the culprit when a 54-year-old woman presented with a five-day history of pain in the left lower quadrant of the abdomen and subjective fevers. Her white blood cell count on admission was elevated at 19.1 x 10^sup 3^ cells/mm^sup 3^. Her medical history included diverticulosis. A computed tomography scan of the abdomen with intravenous (IV) and oral contrast revealed an area of fat stranding adjacent to diverticulosis of the proximal sigmoid colon. This finding was consistent with acute diverticulitis. The patient began a regimen of IV ciprbfloxacin and IV metronidazole. Yet, during the next four days, her pain worsened, and she required increasing amounts of pain medication. Here, Bleich presents her assessment, diagnosis, and management.