History A 33-year-old female presents complaining of severe left-sided abdominal pain. The pain woke her in the early hours of the morning and has persisted throughout the day. She is unable to keep still and has vomited bilious material on five occasions. She reports no diarrhea or rectal bleeding. Previous medical history includes appendicectomy and irritable bowel syndrome. She has had a recent colonoscopy, which was normal. She takes mebeverine for irritable bowel syndrome and multivitamin tablets.
She smokes 15 cigarettes per day. Examination On examination, she has a temperature of 37°C, a blood pressure of 125/88 mmHg and pulse rate of 96/min. There is marked left loin tenderness, but the rest of the abdomen is non-tender. Heart sounds are normal and the chest is clear. Investigations What should be the initial management in this case? *This image-based content is from the…
