Soru

A 31-year-old woman comes to the emergency department due to the sudden onset of severe, unremitting mid-abdominal pain that began 6 hours ago. The pain is associated with nausea and multiple episodes of non-bilious vomiting. Two years ago, she underwent a laparoscopic Roux-en-Y gastric bypass for morbid obesity, losing $45\text{ kg}$ ($99\text{ lb}$) since the procedure. Her temperature is $38.2^\circ\text{C}$ ($100.8^\circ\text{F}$), pulse is $126\text{/min}$, and blood pressure is $90/58\text{ mm Hg}$. Physical examination shows a significantly distended abdomen that is exquisitely tender to palpation, with involuntary guarding and rebound tenderness. Laboratory evaluation reveals a leukocyte count of $17,500\text{/mm}^3$ and a serum lactate level of $4.8\text{ mmol/L}$. A computed tomography scan of the abdomen demonstrates dilated loops of small intestine with a 'swirl sign' of the mesenteric vessels. Which of the following is the most appropriate next step in management?