51M with а PMHx оf umbilicаl herniа presents tо the ED with a 24-hоur history of severe abdominal pain, nausea/vomiting, and cramping. VS are as follows: Temp 38C HR 121 (sinus tachycardia thank you *SO* much for asking RR 32 BP 87/44 Common things are common, the most likely complication is:
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