Soru

A 36-year-old woman arrives at the emergency department reporting three days of progressively worsening, colicky abdominal pain. She has not passed flatus or had a bowel movement during this period. The patient is an avid long-distance runner and has no history of prior abdominal surgeries or significant medical conditions. Her vital signs are temperature 37.3°C (99.1°F), pulse 102/min, respirations 18/min, and blood pressure 118/78 mm Hg. On physical examination, her abdomen is asymmetric, markedly distended, and tympanitic on percussion. Auscultation reveals high-pitched, metallic bowel sounds. Deep palpation elicits diffuse tenderness, but there is no rigidity or rebound tenderness. Laboratory tests demonstrate a leukocyte count of 9,500/mm³ and serum potassium of 3.8 mEq/L. A contrast-enhanced abdominal CT scan reveals a massively dilated, gas-filled cecum displaced into the left upper quadrant, accompanied by a twisting of the mesenteric vessels in the right mid-abdomen. The distal colon is entirely decompressed. Which of the following is the most appropriate next step in the management of this patient?