CASE
A 77-year-old female presented to the emergency department with chronic bloody diarrhea accompanied by severe abdominal pain and progressive generalized weakness that had begun roughly 1 week earlier. She reported 5 to 6 bowel movements daily. The patient's history included a recent diagnosis of pancreatic cancer as well as hypertension, dyslipidemia, chronic obstructive pulmonary disease (COPD), insulin-dependent diabetes mellitus, and diverticulosis. The surgical history was significant for a right hip replacement, cardiac pacemaker placement, and an artificial mitral valve.
Physical examination revealed a soft abdomen with diffuse tenderness, voluntary guarding, and hypoactive bowel sounds. Laboratory testing was significant for acute renal failure, metabolic acidosis, hyperkalemia, anemia, and coagulopathy with an international normalized ratio of 9. Radiography and CT of the abdomen were obtained (Figure 1). What do the images reveal?