Finding-the-Path: Case 17
History
A 65-year-old man presents to the emergency room with lower abdominal pain, pneumaturia and fever. On physical examination, his temperature is 39 degrees Celcius and his pulse is 95. He has moderate left lower quadrant and suprapubic tenderness but no guarding or rebound. His stool is guaiac positive on rectal exam. His white blood cell count (WBC) is 16 K/µl with 80% neutrophils and 5% bands. Supine and upright plain radiographs of the abdomen are unremarkable.
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