Soru

An otherwise healthy 55-year-old man arrives at the emergency department complaining of excruciating, generalized abdominal pain that began $24$ hours ago. The pain is accompanied by intractable nausea and multiple episodes of bilious vomiting. He reports no passage of stool or flatus since the symptoms started. His past surgical history is notable for an uncomplicated open appendectomy over a decade ago. Vital signs show a temperature of $38.6^\circ\text{C}$ ($101.5^\circ\text{F}$), a blood pressure of $98/60$ mm Hg, and a heart rate of $118$/min. Physical examination reveals a markedly distended and tympanic abdomen. There is diffuse, severe tenderness to palpation, accompanied by involuntary guarding and marked rebound tenderness. Bowel sounds are absent. Initial laboratory testing is significant for a leukocyte count of $18,500/\text{mm}^3$ and a serum lactate concentration of $4.8$ mmol/L. Upright abdominal radiography demonstrates multiple dilated loops of small intestine with prominent air-fluid levels and an absence of distal colonic gas. Which of the following is the most appropriate next step in the management of this patient?