A 41-year-old man with a history of cocaine abuse was admitted with diffuse abdominal pain and bloody stools. Patient History : One year previously the patient was diagnosed with hepatitis C, genotype 1A with a positive HCV RNA. A fibroscan had revealed normal values without indications of cirrhosis. Owing to lack of compliance no treatment of HCV was initiated. Physical Examination : On admission, physical examination revealed tenderness in the right lower quadrant with a maximum at McBurney’s point.
The patient was feverish with a body temperature of 38.3°C and had elevated C-reactive protein at 14 mg/dL and a white blood cell count of 14,500/dL. Based on the clinical assessment and ultrasound imaging appendicitis was ruled out. A subsequent contrast-enhanced abdominal computed tomography and colonoscopy was performed (images attached). What is the likely diagnosis and treatment in…
