A 75-year-old man arrives at the ED with abdominal pain. He reports having left-sided abdominal pain over the last 2 days, which is relieved temporarily after defecation. He has a temperature of 101.2 °F, a blood pressure of 142/88 mmHg, and a pulse of 88/min. His laboratory examination is significant for a WBC of 14 × 10^3/μL (normal 4.1-10.9 × 10^3/μL) with 10% bands. CT imaging reveals focal sigmoidal wall thickening with significant paracolic inflammation. He was treated as an in-patient for 3 days and discharged home without complications.

Which of the following is the most appropriate follow-up option?

A. High-fiber diet alone
B. CT scan 2 weeks after resolution
C. Elective sigmoid colectomy
D. Barium enema
E. Colonoscopy

The appropriate follow-up for a patient treated for acute diverticulitis is a colonoscopy to assess the condition of the colon and rule out other potential issues like malignancy. The correct option is (E) Colonoscopy.

Explanation:

The most appropriate follow-up option for a 75-year-old man who was discharged after being treated for acute diverticulitis with focal sigmoidal wall thickening and paracolic inflammation is (E) Colonoscopy. After resolution of an acute episode, a colonoscopy is typically recommended several weeks later to evaluate the extent of the disease, rule out malignancy, and ensure that the inflammation has resolved. While dietary modifications like a high-fiber diet are important for overall colonic health, it would not be the sole follow-up after such an acute event. A CT scan, elective sigmoid colectomy, or barium enema may not be immediately necessary unless there are complications or ongoing symptoms that require further interventions.