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A 61-Year-Old Man Comes to the Emergency Department with Abdominal

question 480

Multiple Choice

A 61-year-old man comes to the emergency department with abdominal pain for the past 2 days. He has lower abdominal discomfort and generalized malaise but no nausea, vomiting, back pain, or urinary symptoms. His last bowel movement was yesterday. The stool was formed but did not relieve the pain. He has never had a colonoscopy. His father was diagnosed with colon cancer at age 65.
His temperature is 37.8 C (100 F) , blood pressure is 122/70 mm Hg, and pulse is 92/min. Mucous membranes are moist. There is moderate tenderness in the left lower quadrant without rebound tenderness.
Laboratory results are as follows:

Computed tomography of the abdomen with contrast shows sigmoid wall thickening and increased density of the pericolic fat.
Which of the following is the best management for this patient?

Definitions:

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