Soru

A previously healthy $59$-year-old male is brought to the surgical triage unit by his family after developing sudden, severe, and constant lower abdominal pain accompanied by multiple episodes of bilious emesis. The symptoms began $12$ hours prior to arrival, and he has not passed stool or flatus since the onset. He denies any prior abdominal operations. Vital signs include a temperature of $38.5^\circ\text{C}$ ($101.3^\circ\text{F}$), a blood pressure of $96/60\text{ mmHg}$, and a heart rate of $118\text{/min}$. Abdominal examination reveals significant distension, hypoactive bowel sounds, and involuntary guarding. A tense, irreducible $5\text{-cm}$ bulge is noted in the right inguinal region. The skin overlying the bulge is dusky and erythematous. Laboratory studies are significant for a leukocyte count of $18,500\text{/mm}^3$ and a serum lactate of $4.2\text{ mmol/L}$. Which of the following is the most appropriate next step in management?