امرأة عمرها ٤٤ سنة بعد عملية في الأمعاء بأربعة أيام، كانت تتحسن. فجأة صار عندها ألم بطن منتشر شديد يزيد مع الحركة، والبطن قاسٍ، وأصوات الأمعاء غائبة. الحرارة ٣٩٫٠، والنبض ١٢٦، والضغط ٩٤/٥٨. ما المضاعفة الأرجح؟

A 44-year-old woman 4 days after bowel surgery had been improving. Suddenly she has severe diffuse abdominal pain worse with movement, a rigid abdomen and absent bowel sounds. T 39.0 °C, HR 126, BP 94/58. What is the most likely complication?

1. Normal incisional pain after surgery
2. Anastomotic leak with peritonitis
3. Mild ileus that improves with walking
4. Constipation from immobility and opioids

Answer: B) Anastomotic leak with peritonitis. Diffuse pain with rigidity, fever, tachycardia and hypotension after bowel surgery indicate an anastomotic leak with peritonitis until proven otherwise; notify immediately, give fluids and antibiotics and arrange surgical review.