Subtotal colectomy and right iliac fossa ileostomy demonstrated.
There is free intraperitoneal gas and demonstrated mural gas, which is widespread. Diffuse hypoenhancement of the bowel wall. The duodenum is thick walled and demonstrates prominent mural enhancement. Extensive portal venous gas remains present. The ascites has resolved.
Multiple bilateral peripheral wedge-shaped hypodensities are demonstrated within both kidneys. Within hepatic segment 4B, a para-falciform region of low attenuation most likely represents focal fatty infiltration. Cholelithiasis.
Conclusion
Diffuse bowel hypoenhancement and mural gas, consistent with infarction, as well as free intraperitoneal gas, consistent with perforation. Bilateral wedge-shaped renal hypodensities are highly suspicious for infarcts.