Case 404

Medical history

A 36-year-old male patient comes to the Emergency Care Unit with complaints of pain in the left lower quadrant (LLQ) of the abdomen for two days. Physiological habits preserved, without gastrointestinal complaints. On physical examination, he was in good general condition, afebrile, with a normotensive abdomen, painful palpation of the left iliac region, without signs of peritonitis. Laboratory tests (blood count and urinalysis) without abnormalities. Computed tomography (CT) of the abdomen and pelvis was requested for diagnostic clarification (images 1 and 2).

Based on the clinical case described and the alterations in the imaging exam, what is the probable diagnosis of this patient?

Test question

A 59-year-old woman comes to the emergency department with abdominal pain in the left iliac region for 3 days, worsening for 1 day, hyporexia and two episodes of fever of 38ºC in the last 24h. On physical examination, good general condition, HR of 88 bpm, flat abdomen, painful on palpation of the left iliac region, with local defense and positive Blumberg sign. Chest and abdomen X-rays without changes. CBC shows 16,000 white blood cells with 5% band cells. Normal kidney function. The most suitable test for diagnostic confirmation is:

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