Abstract
A 66-year-old man presented with a 20-day history of constipation, lower abdominal and back pain, and fever. Two days before admission, his symptoms worsened, with nausea and passing flatus but not stool. The patient's medical history included acute diverticulitis that was managed conservatively. The abdomen was soft and slightly distended, with mild tenderness in the lower quadrants. The laboratory results showed leukocytosis (white-cell count, 10,890 per cubic millimeter). Plain radiography showed a large air bubble (>10 cm in diameter) centrally located in the abdomen (Panel A). Urgent abdominal computed tomography (CT), without the use of contrast medium, suggested that the . . .
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