Case presentation A 61-year-old man presented to the emergency room complaining of 3 days of worsening abdominal pain. The pain is localized to the left lower quadrant of his abdomen. It began as an intermittent cramp and has become steady and moderately severe. The patient feels nauseated, but he has not vomited.
He had a small loose stool at the beginning of this illness, but he has not had any bowel movements since. Physical examination Temperature - 100.2°F Heart rate - 98 bpm Blood pressure - 110/72 mm Hg No pallor or jaundice Chest – Clear Heart rhythm - Regular without murmurs Abdomen - Mildly distended with hypoactive bowel sounds and marked left lower quadrant tenderness with voluntary guarding Rectal examination reveals tenderness, and his stool is negative for occult blood. Laboratory studies are significant for a white blood cell (WBC) count of 11,800/mm3 with 74%…
