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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which started 36 hours earlier. He has noticed mild, periodic discomfort in this region before but has not sought medical treatment. He reports nausea, anorexia, and vomiting associated with any oral intake. On physical examination, his temperature is 38.5°C and his heart rate is 110 beats per
The Clinical Problem
Diagnosis and Evaluation
Staging
Imaging and Endoscopy
Hospitalization
Percutaneous Drainage
Operative Intervention
Laparoscopic Procedures
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Surgery, Duke University School of Medicine, and Duke University Hospital, Durham, NC.
Address reprint requests to Dr. Jacobs at the Department of Surgery, Duke University Medical Center, DUMC Box 3704, Durham, NC 27710.
This article has been cited by other articles:
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