ABSTRACT
Unlike other diseases in this text diverticular disease is a common problem with multiple presentations.
CHALLENGING CASE #1 A 52-year-old male presents to the Emergency Department with complaints of left lower quadrant (LLQ) abdominal pain for the last 16 hours. The patient describes the pain as escalating in nature, unrelieved with a bowel movement. History is unremarkable except for hypertension, which is treated with a beta-blocker. The patient denies any similar symptoms previously. Abdominal exam reveals a mildly distended abdomen, with tenderness to the left lower quadrant, but no guarding or rigidity. A basic metabolic profile is normal and complete blood count reveals a leukocytosis at 14,000. CT scan of the abdomen and pelvis with oral and rectal contrast demonstrates thickening of the sigmoid colon with mesenteric thickening but no identifiable abscess or perforation.
