45 year old male patient became to physician because of sever abdominal pain and abdominal distention with diffuse ab tenderness with anorexia ; which occur 9 days before then coming increase and sever . Before the last day the patient had been passing stool but now can’t . 9 yr ago the patient had hospitalized due to pulmonary embolism. bp 125/82,HR 123/min
Spo2 85% RR 18/min , wbc were 16500/microlit, liver function test was normal, urinalysis normal, ab ultrasonography shows free fluid in ab cavity, ab flain x _ ray shows excessive gas in GI tract ,CT and other nessecery tests are not available , the surgeon decided to do exploratory laperatomy to patient what would be diagnosis ???
A_ Intestinal obstruction
B_ mesenteric thromboembolism
C_toxic mega colon
D_ peptic ulcer perforation
E_ ischemic colitis
The patient had been mesenteric thromboembolism complicated to intestinal gangrene and 80 cm small intestine resected