Inflammatory Bowel Disease

  • Jack Pickleman


A 73-year-old man presents to the emergency room with an 8-hr history of progressive lower abdominal pain. His temperature is 38.1°C, and his abdomen is diffusely tender, with peritoneal signs present in both lower quadrants. A white blood cell count is 9800 cells/mm3, and four views of the abdomen disclose only ileus. After volume resuscitation and antibiotic treatment, he undergoes celiotomy. An inflammatory mass of the sigmoid colon is noted, with a small perforation partially sealed off by the omentum. Several hundred cc of turbid fluid are present in the pelvis. Treatment should consist of:
  1. A.

    Sigmoid resection and primary anastomosis.

  2. B.

    Sigmoid resection, end sigmoid colostomy, and oversewing of rectum.

  3. C.

    Transverse colostomy.

  4. D.

    Transverse colostomy and drainage of the mass.

  5. E.

    Transverse colostomy, drainage of the mass, and postoperative peritoneal lavage.



Inflammatory Bowel Disease Ulcerative Colitis Barium Enema Rectovaginal Fistula Toxic Megacolon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Jack Pickleman
    • 1
  1. 1.Loyola University Stritch School of MedicineMaywoodUSA

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