A 47-year-old woman presented to the ED on November 6 with abdominal pain. The patient had undergone a Roux-en-Y gastric bypass surgery on October 20. She had developed worsening abdominal pain, and went to see a nurse practitioner at an outpatient clinic. She was given Rocephin and Phenergan, and then referred to the ED.
On arrival to the ED, the patient was seen by a physician. The T-sheet is shown below. The copies entered in the trial for this case are of particularly poor quality, therefore a summary of the information is shown below. The chief complaint is left abdominal wall abscess/drainage. Onset was today. Context: bypass on 10/20, now with incisional infection and drainage at L upper abdomen. A set of vitals revealed a temperature of 100.3 F, BP 141/74, HR 114, respirations 28/min, 100% O2 sat. The patient was noted to be in moderate distress. She had ecchymosis on her right side with a drain, the incision had purulent material and there was surrounding cellulitis. A CT with contrast was ordered to rule out abscess. An IV was started, she was given 1L NS bolus, several doses of morphine and Zofran.
Chemistry:
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CBC:
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A CT scan was ordered. The results are below.
Given this information, what would be the appropriate next steps? Can this patient be discharged?