A 55-year-old female was admitted to the hospital with the chief complaint of episodes of paroxysmal abdominal pain. The pain started two weeks before, which aggravated since the last two days with nausea, vomiting, and constipation. Past medical and surgical history revealed that she was diabetic since last 12 years and was on oral metformin 500 mg three times a day, and she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO) sixteen months ago for uterine leiomyosarcoma. During the physical examination, moderate tenderness over the right epigastric and hypochondrial areas and active bowel sounds were observed.
Plain abdominal X-ray showed dilatation of small bowel without any gas-fluid levels. Baseline hematology showed leukocytosis, high absolute neutrophil count, and normal hemoglobin and platelets counts. Serum chemistry showed lactate dehydrogenase was…
