Chronic ulcerative colitis is a potential risk factor for cancer.
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 23-year-old American Jewish woman comes to the emergency department due to a 4-day history of fever, left lower quadrant pain, and abdominal distention. Her medical history is relevant for Hashimoto's hypothyroidism, situational anxiety, and positive family history of inflammatory bowel disease. The patient currently takes levothyroxine, vitamin C/zinc supplement, and alprazolam. Upon further questioning, the patient mentions that she has increasing bowel movements (every hour) and has small amounts of watery-mucousy red stools. Physical exam shows distended abdomen and tympanitic, drum-like sounds over her right upper and left upper quadrant. Her temperature is 38.6°C (101.48°F), pulse is 121/min, respirations are 18/min, blood pressure is 80/70 mmHg. Upon hospital admission, the patient's clinical condition deteriorates despite antibiotic therapy and steroids. An abdominal radiograph is obtained and shown below.
Which of the following is the most likely cause of this patient's condition?