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Perforated diverticulitis with septic shock — RCPSC EM MCQ

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HardGI/Abdominal emergenciesPerforated diverticulitis with septic shockRCPSC EM

A 70-year-old man has severe left lower quadrant pain, fever, and hypotension. CT shows sigmoid diverticulitis with free perforation and diffuse faecal peritonitis. Lactate is 5.2 mmol/L despite fluids. What is the most appropriate initial management?

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Correct answer: C — Broad-spectrum IV antibiotics, sepsis resuscitation, and emergency surgery

Perforated diverticulitis with diffuse peritonitis and septic shock requires sepsis resuscitation, broad-spectrum antibiotics, and urgent operative source control.

Reference: Canadian emergency surgery practice; Surviving Sepsis Campaign