Final answer:
A 29-year-old woman with ulcerative colitis presenting with fever and acute abdominal symptoms requires stabilization, laboratory and imaging studies, intravenous fluids, broad-spectrum antibiotics, and a surgical consult. Close monitoring and multidisciplinary team involvement are essential for managing potential complications and initiating appropriate UC flare management.
Step-by-step explanation:
The management of a 29-year-old woman with ulcerative colitis (UC) presenting to the emergency department with fever, stable blood pressure, tachycardia, abdominal distension, and acute tenderness should be approached with urgency. Initial assessment should focus on vital sign stabilization and laboratory investigations including a complete blood count (CBC), inflammatory markers, and blood cultures. Imaging studies such as an abdominal X-ray or CT scan may be required to evaluate for complications such as toxic megacolon or perforation.
Prompt initiation of intravenous fluids, correction of electrolyte imbalances, and broad-spectrum antibiotics are important for the management of potential septic complications. A surgical consult should be obtained to assess the need for emergency intervention, especially in the context of suspected perforation or if toxic megacolon is present.
Close monitoring and potential escalation of care to an intensive care setting may be necessary depending on the patient's response to initial management and evolution of her clinical state. Management of UC flare could include intravenous corticosteroids, and in the case of refractory disease, other options such as cyclosporine or infliximab could be considered based on specialist input. It is critical to work in a multidisciplinary team involving gastroenterologists, surgeons, and intensivists for optimal patient outcomes.