ROSH Gastrointestinal Practice Exam

What condition would you most likely find in a patient presenting with left lower quadrant pain and sudden bowel habit changes?

1. Appendiceal wall thickening

2. Colonic diverticula

3. Dilated loops of small bowel

4. Enlarged pericolonic lymph nodes

The correct answer is: Colonic diverticula

In this scenario, the condition most likely associated with left lower quadrant pain and sudden changes in bowel habits is the presence of colonic diverticula. Diverticular disease, which includes diverticulitis, often presents with localized pain in the left lower quadrant due to the common site of diverticula formation in the sigmoid colon. Additionally, patients may experience alterations in bowel habits such as diarrhea or constipation, often linked to inflammation or infection of the diverticula. Diverticular disease can lead to diverticulitis, where the diverticula become inflamed or infected, prompting both the characteristic pain and bowel habit changes in these patients. This makes it a fitting choice for the given symptoms, as the acute nature of the pain and the change in bowel habits are hallmark signs of an active diverticular episode. Other choices may present with abdominal symptoms, but they are less specific for the combination of left lower quadrant pain and acute changes in bowel habits. For instance, appendiceal wall thickening typically relates to appendicitis, which usually presents with right lower quadrant pain. Dilated loops of small bowel suggest an obstruction rather than being localized to the left lower quadrant, while enlarged pericolonic lymph nodes might indicate an underlying infection or malignancy but do not directly correlate