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A marginally housed man in his 50s with a history of alcohol use disorder and essential hypertension presented to the emergency department with abdominal pain for 2 days. On presentation, his vitals were within normal limits. His abdomen was soft, nondistended, and tender in the left lower quadrant with voluntary guarding but no rebound tenderness. He reported his pain as a 6 on a 10-point scale. Laboratory results revealed a white blood cell count of 9.9 × 109/L, liver function test results were within normal limits, a serum creatinine of 0.68 mg/dL (to convert to μmol/L, multiply by 88.4), and a lipase of 29 U/L (to convert to μkat/L, multiply by 0.0167). Urinalysis results were within normal limits. Computed tomographic (CT) imaging of his abdomen demonstrated bowel wall thickening of a sigmoid diverticulum without perforation, consistent with acute uncomplicated diverticulitis. The patient was given ertapenem in the emergency department and discharged with a 10-day course of amoxicillin-clavulanate.
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Corresponding Author: Bharat Maraj, MD, Department of Internal Medicine, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143 (firstname.lastname@example.org).
Published Online: July 30, 2018. doi:10.1001/jamainternmed.2018.3507
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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