A HEALTHY 27-year-old man had a 3-day history of left lower quadrant abdominal pain, anorexia, nausea, vomiting, and diarrhea. Physical examination results were remarkable for a temperature of 39°C with rebound tenderness and guarding in the left lower quadrant. Laboratory values were significant for a white blood cell count of 12.3 × 109/L, and abdominal x-rays showed a gas pattern consistent with an ileus. A computed tomographic scan of the abdomen is shown in Figure 1.
A. Small-bowel intussusception
B. Acute left-sided appendicitis
C. Ulcerative colitis
D. Crohn disease
E. Acute diverticulitis
Corresponding author and reprints: Jeffrey M. Nicholas, MD, MS, Department of Surgery, Room 308, Glenn Memorial Bldg, 69 Butler St SE, Atlanta, GA 30303 (e-mail: Jeffrey_Nicholas@emory.org).
Nicholas JM, Rozycki GS. Image of the Month. Arch Surg. 2001;136(6):705–706. doi: