The patient is moved to the surgical intensive care unit, where he is intubated on inotropic support. Carcinomatosis of stomach, liver, and spleen.Multiple peritoneal neoplastic deposits.Phlegmon involving the stomach and large bowel.Intraoperative findings include the following: The surgeons note that both surgical margins appear to be tumor-free away from both surgical margins. Surgery involves excision of a 65-cm piece of colon and a peritoneal nodule, which are sent for histopathological analysis. Erythrocyte sedimentation rate elevation: 118 mm/hr.Leukocytosis (32.500 × 10 9/L): mainly neutrophils and monocytes.
Peripheral capillary oxygen saturation: 98%.Fluid wave test is positive clinicians are not able to assess for organomegaly. The abdomen was distended, with epigastric tenderness. There is no evidence of cervical lymphadenopathy. He displays considerable pain and distress during the examination. Clinicians note marked abdominal distension and epigastric tenderness. Physical examination finds the patient conscious and fully aware of his surroundings. He has not consumed alcohol or used illicit drugs, and there is no family history of gastrointestinal malignancies. Similarly, he has had no abdominal injury. Clinicians taking the patient's history note that he has not had any loss of appetite, nausea or vomiting, or dark or bloody stools.
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