A patient underwent midline laparotomy due to cholecystitis and ileus (which developed as a complication of previous surgery performed due to fracture of the cervical vertebral column) ten days ago. Cholecystectomy and decompression of the intestine were done.

Elevation of inflammatory markers. The region of previous surgery of the cervical vertebral column is calm. There are signs of ventilator-associated pneumonia (= VAP) – the patient still has a tracheostomy and receives mechanical ventilation. The abdomen is above the level of the chest, without signs of peritoneal irritation. Wound after laparotomy is stiff and slightly red. Palpation does not reveal evident fluctuation.

 

Abdominal ultrasonography was normal apart from these findings:

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