Abstract
A 45-year-old woman with a medical history of constipation and irritable bowel syndrome presented with cramps in the left lower abdomen. She had experienced these symptoms for about 2 months. The symptoms were accompanied by decreased appetite and weight loss of 6 kg over 2 months. For a few weeks, she experienced fevers up to 39°C and cold shivers. Physical examination revealed tenderness in the left lower quadrant of the abdomen, without a palpable mass. A mass anterior to the rectum was felt with digital rectal examination. Laboratory findings included an elevated C-reactive protein level of 160 mg/L (normal range, 10 mg/L), an elevated erythrocyte sedimentation rate of 108 mm/h (normal range, 20 mm/h), and a high white blood cell count of 17.9 10/L (normal range, [4.3–10.0] 10/L). Contrast material–enhanced abdominal computed tomography (CT) was performed.
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