A 62 year old woman presents with pain in the left lower abdomen for 6 hours. She also passed a moderate amount of bright red blood per rectum last night. There is no history of nausea, vomiting, dysuria, or diarrhea, and this is her first such episode. Her bowel habits have not changed recently. Her medical and family histories are unremarkable, and she is not on any medications.
WBC/DC: 13,000/mm3 (4,600-11,000) N: 80% L:15% Hb: 12.2 g/dL (11.0-18.0) Hct (PCV): 38% Platelets: 209,000/mm3 (150,000-400,000) C-reactive protein: 96 mg/L
The graded compression ultrasound scan of the abdomen reveals focal thickening of the walls of the sigmoid colon. No other abnormalities are noted.
There is focal thickening of the walls of the sigmoid colon, along with multiple diverticula. The arrowhead sign is noted in association with a diverticulum. There are no abscesses, or intra-abdominal free fluid or free air.
You realize that colonoscopy is best postponed until later.