Approach to postoperative wound complications Quiz: Ace Your Exams
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A 46-year-old man is admitted to the hospital for evaluation of abdominal pain and fever 5 days after a hemicolectomy that was performed to remove an ascending colonic mass. The fever started on postoperative day 2 and was associated with progressively worsening abdominal pain most pronounced in the right lower quadrant. He rates the abdominal pain as an 8/10. He has nausea but no vomiting and has not had a bowel movement since his surgery. Temperature is 38.4°C (101.2°F), pulse is 107/minute, blood pressure is 118/78, respiratory rate is 18/minute, and oxygen saturation is 93% on room air. The patient appears uncomfortable. The incision is clean, dry, and intact with no palpable fluctuance or erythema. Decreased bowel sounds are heard and there is tenderness to palpation in the right lower quadrant without rebound or guarding. Labs are significant for a white blood cell count of 16K, elevated ESR, and CRP. Which of the following should be ordered next?
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