A 71-year-old man arrives as ESI 2 with left lower quadrant pain, fever, and vomiting. BP 96/58, HR 122, WBC 20,000/mcL, lactate 3.6 mmol/L. CT shows

Question

A 71-year-old man arrives as ESI 2 with left lower quadrant pain, fever, and vomiting. BP 96/58, HR 122, WBC 20,000/mcL, lactate 3.6 mmol/L. CT shows perforated sigmoid diverticulitis with free air. Which of the following is the most appropriate next step in management?

Accepted Answer

Administer broad-spectrum IV antibiotics and obtain emergency surgical consultation

Answer

Schedule elective colonoscopy tomorrow

Answer

Give loperamide and observe

Answer

Discharge on oral antibiotics

Answer

Perform barium enema

Perforated diverticulitis — ABEM Board MCQ

A 71-year-old man arrives as ESI 2 with left lower quadrant pain, fever, and vomiting. BP 96/58, HR 122, WBC 20,000/mcL, lactate 3.6 mmol/L. CT shows perforated sigmoid diverticulitis with free air. Which of the following is the most appropriate next step in management?