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Diverticulitis with abscess — SCE Acute Medicine MCQ

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EasyAcute Gastrointestinal PresentationsDiverticulitis with abscessSCE Acute Medicine

A 51-year-old woman presents with acute abdominal pain, bleeding, jaundice or vomiting. Relevant history includes gastrointestinal or hepatobiliary risk factors. On assessment, abdominal examination and physiology suggest significant acute illness. Investigations show CT shows sigmoid diverticulitis with a 5 cm abscess. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Admit for IV antibiotics and consider percutaneous drainage

The key discriminator is that CT shows sigmoid diverticulitis with a 5 cm abscess, which makes Admit for IV antibiotics and consider percutaneous drainage the single best answer. Arrange routine outpatient follow-up is less appropriate because it does not address the dominant acute risk in the vignette; Provide supportive care and close monitoring would fit a different presentation or later stage of care. Call critical care for escalation and Give analgesia and antiemetic therapy are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG147