A 65-year-old woman develops obstipation, lower abdominal pain, and fever. Physical examination reveals a temperature of 38.5°C, left lower quadrant tenderness, and an ill-defined lower abdominal mass. White blood count is 17,500 per mm3. Intravenous hydration, broad spectrum antibiotics, and analgesics are ordered. After 48 hours, symptoms have not improved. Appropriate management includes which of the following?
A. Barium enema
B. Computed tomography of the abdomen
C. Immediate laparotomy
D. Intravenous pyelogram
Answer:B
A 65-year-old woman develops obstipation, lower abdominal pain, and fever. Physical examination reveals a temperature of 38.5°C, left lower quadrant tenderness, and an ill-defined lower abdominal mass. White blood count is 17,500 per mm3. Intravenous hydration, broad spectrum antibiotics, and analgesics are ordered. After 48 hours, symptoms have not improved. Appropriate management includes which of the following?
A. Barium enema B. Computed tomography of the abdomen C. Immediate laparotomy D. Intravenous pyelogram