RT Journal
A1 Ratnapala DN, Lisle D, Munn E, Lambrianides AL
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD November 16
VO 144
IS 11
SP 1087
OP 1087
DO 10.1001/archsurg.2009.187-a
UL http://dx.doi.org/10.1001/archsurg.2009.187-a
AB 
On examination, the patient was in sinus rhythm, was moderately dehydrated, had right-sided abdominal tenderness, and had no organomegaly or palpable masses. Digital rectal examination results were negative for blood. Laboratory tests showed moderate leukocytosis (white blood cell count, 15 600/μL [to convert to ×109per liter, multiply by 0.001]; with an elevated neutrophil count of 13 600/μL), an elevated C-reactive protein level (157 mg/L [to convert to nanomoles per liter, multiply by 9.524]), and an erythrocyte sedimentation rate of 32 mm/h. Arterial blood gas showed no lactic acidosis. Stool culture results were negative for pathogenic growth as well as for Clostridium difficiletoxin. The patient was admitted for resuscitation and investigation.