A 65-year-old woman presented to the emergency department with complaints of acute diffuse abdominal pain that had begun ten hours earlier. Medical history The patient did not have any history of any pre-existing gastrointestinal disorders and medication. One month ago, she was treated with double oophorectomy and salpingectomy for ovarian cancer.
Ten days before the presentation, bevacizumab was given as postoperative adjuvant therapy. Vitals Hemodynamically unstable Afebrile Blood Pressure: 115/80 mmHg Physical examination Abdominal distension Diminished bowel sounds Severe tenderness with peritoneal signs in all of the abdominal quadrants Laboratory examination Neutrophils: 7.77 K/μL (Normal- 5 to 10 K/uL) C-reactive protein: 82.46 mg/dl (0.3 to 1.0 mg/dL ) Sodium: 119 mEq/L (135 to 145 mEq/L) Radiological investigations After initial resuscitation, a CT scan showed free abdominal…
