Question

A 55-year-old obese man presents to the emergency department with abdominal pain. His pain started 2 days ago and has been worsening steadily. His only current medication is allopurinol. His temperature is 101.0°F (38.3°C), blood pressure is 157/98 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam is notable for left lower quadrant abdominal tenderness and rectal exam is unremarkable. A CT scan is performed demonstrating inflamed outpouchings of the colonic mucosa with a 4-cm abscess. Which of the following is appropriate treatment of this patient?

a. Ciprofloxacin and gentamicin
b. CT-guided percutaneous drainage
c. Laparoscopy and drainage
d. Piperacillin-tazobactam and vancomycin
e. Supportive therapy and observation until symptoms abate

Answer 1

The appropriate treatment for this patient is CT-guided percutaneous drainage.

Step-by-step explanation:

The appropriate treatment for this patient is CT-guided percutaneous drainage. Based on the clinical presentation and imaging findings of an inflamed outpouching of the colonic mucosa with an abscess, CT-guided percutaneous drainage is the most appropriate initial treatment option. This procedure involves using CT guidance to drain the abscess and can be performed without the need for a surgical intervention.