0

A 25-year-old man presents to the emergency department with worsening intermittent, colicky abdominal pain of 1 week’s duration. He has experienced several weeks of irregular bowel habits and loose stools. Examination reveals right lower quadrant tenderness without guarding or rebound; his white blood cell count is 20,000/µL (20109/L) with 80% polymorphonuclear leukocytes. Computed tomography reveals marked edema of the terminal ileum with a comb sign, a loss of fat planes, and narrowing of the lumen. The appendix is not seen. What is the best next step in management?

There's more to see -- the rest of this topic is available only to subscribers.