There may be a low-grade fever but the patient is not tachycardic. Examination reveals mild left lower quadrant tenderness without an appreciable mass. Solid foods may be started as symptoms subside and a high fiber diet instituted after resolution of the inflammation. The patient with this stage of inflammation will complain of moderate to severe left lower abdominal pain and anorexia. Alteration in normal bowel habits with constipation or diarrhea will occur.
Abdominal exam reveals a tender mass and voluntary guarding in the lower abdomen.
Rebound tenderness or referred rebound tenderness may be present. Pyrexia and tachycardia are usually present. Urinalysis can exclude urinary tract infection, fecaluria, and ureterolithiasis. Leukocytosis is usually present. The patient is best treated with hospitalization, bowel rest, IV hydration, and IV antibiotics.