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Previous Volume 357:2057-2066 November 15, 2007 Number 20 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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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 . . . [Full Text of this Article]

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.

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