A 55-year-old woman presented to the emergency department with abdominal bloating, nausea and vomiting. She was five days post-elective external iliac artery angioplasty and stenting, after which she had developed these symptoms. On examination, her abdomen was soft but mildly tender. Her National Early Warning Score (NEWS) was 31, with a heart rate of 118 bpm and a blood pressure of 106/76 mmHg2.
An abdominal radiograph was requested to assess for possible constipation or bowel obstruction3. Routine blood tests the following day revealed a raised white blood cell (WBCs) count of 15.4 ×109/L (reference: 4.0–10.0), neutrophils of 12.72 ×109/L (2.00–7.00), and monocytes of 1.14 ×109/L (0.20–1.00)4. Other parameters were unremarkable. Post-operative elevated WBCs and neutrophils are likely reflective of an inflammatory/infective process or, in rare cases, an ischemic process also.
The...
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