The clinical presentation is that of lower abdominal pain, fever, and chills. This alone made me think it was an inflammatory process. Also the question says there are 3 separate poorly delimited regions of narrow lumen. As far as ulcerative colitis is concerned, there are no skip lesions, it is continuous wherever it is. This coupled with the history of constipation makes diverticulitis the best answer choice.
I would have easily chosen granulomatous colitis... had i known it is the same thing as Crohns. Shout out to ignorance and its bliss.
Don't this is UC or Crohns. For this question you have to have noticed the age (66 year-old). Lower left quadrant = diverticulitis of elderly & Lower right quadrant = angiodysplasia of elderly (think these were mentioned in Pathoma)
I think it is good to note the demographics. The patient is female and old. That, along with the constipation, made me lean more towards diverticulitis. IBD usually develops in younger persons.
What is with the picture? I just would never pick diverticulitis without seeing a diverticulum...
What does 3 narrowin means? Is that a cause of diverticulary diseases or the result?? And what is that photo means :/
I first chose diverticulitis because of the history, but then I saw the picture, and honestly I wish I hadn't. I didn't see ANY diverticulum, so I thought...hmmm, they're want to "trick" me into choosing diverticulitis, but it's actually "something else"... :'( :'(
remember sigmoid colon has the smallest diameter (hence why Left sided CRC produces the apple core) meaning that it is prone to higher pressures in accordance to laplace' law (pressure inversely proportional to diameter) thus small diameter = high pressure = prone to diverticula formation
I picked Crohn’s too. I think the severe constipation over 5 years distracted me.
submitted by nuts4med(8)
I was thinking Chron’s because of the narrowing of the lumen and the picture seemed like there was creeping fat. Now that I think about it though, the LLQ and constipation should have led towards diverticulitis pretty quickly.