A 65-year-old man with acute diverticulitis develops a 5 cm pelvic abscess. CT scan confirms the collection. The patient is hemodynamically stable. The best initial management is:

• A Intravenous antibiotics alone
• B Emergency Hartmann's procedure
• C Primary anastomosis with diverting ileostomy
• D CT-guided percutaneous drainage ✓

Explanation

For diverticular abscesses larger than 3-4 cm, CT-guided percutaneous drainage is the first-line intervention. It can resolve the acute infection and allow elective surgery if needed. Antibiotics alone are insufficient, and emergency surgery carries high morbidity in the setting of an abscess.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.