A 77-year-old man is admitted to the intensive care unit (ICU) from the operating room. Earlier the same day, he had presented to the emergency department with abdominal pain. Medical history His medical history included treated hypertension and hypercholesterolemia, previous heavy alcohol intake, and mild cognitive impairment. In the emergency department, he was drowsy and confused when roused and was peripherally cold with cyanosis. The systemic arterial blood pressure was 75/50 mm Hg, and the heart rate was 125 beats/minute.
The abdomen was tense and distended. Radiographic Exam A CT scan of the abdomen showed extraluminal gas and suspected extraluminal feces consistent with a perforated sigmoid colon. He was treated with intravenous antibiotics and taken to the operating room for laparotomy. Laparotomy During this procedure, gross fecal peritonitis from a perforated sigmoid colon…
