MSFinals-1521

MSFinals-1521

A 28-year-old man, diagnosed with ulcerative colitis (UC) 18 months ago, presents with 2-day history of progressively worsening abdominal pain and bloody diarrhoea. He is currently passing motion 11 times per day.
On examination, there is generalised abdominal tenderness and distension. He is pyrexial, with a temperature of 39 °C; his pulse is 124 bpm.
Investigations:
Investigation Result Normal value
Haemoglobin (Hb) 90 g/l 135–175 g/l
White cell count (WCC) 15 × 109/l 4–11 × 109/l
Erect chest X-ray Normal
Plain abdominal X-ray 12-cm dilation of the transverse colon
He also has a raised C-reactive protein (CRP).
What would be the most appropriate initial management of this patient?