Soru

A 64-year-old woman presents to the emergency department with a 6-hour history of sudden, severe, and continuous abdominal pain accompanied by two episodes of bilious vomiting. Her medical history includes hypertension, paroxysmal atrial fibrillation, and an open total abdominal hysterectomy performed 10 years ago. Her current medications are lisinopril and metoprolol; she is not taking anticoagulation. Temperature is $38.2^\circ\text{C}$ ($100.8^\circ\text{F}$), pulse is $122/\text{min}$ and irregularly irregular, blood pressure is $94/60\text{ mm Hg}$, and respirations are $24/\text{min}$. Physical examination shows a mildly distended abdomen. There is marked focal tenderness in the left lower quadrant with rigidity and rebound tenderness. Bowel sounds are absent. Laboratory studies show a leukocyte count of $17,500/\text{mm}^3$ and a serum lactate level of $4.2\text{ mmol/L}$. Computed tomography of the abdomen and pelvis with intravenous contrast reveals a high-grade small bowel obstruction with a radially distributed, U-shaped cluster of dilated small bowel loops. The mesenteric vessels converge toward a central point, and the wall of the affected bowel loop is thickened with diminished contrast enhancement. Which of the following is the most appropriate next step in management?