A 14 year old boy arrives in the emergency room with a razor slash in the right lower quadrant of his abdomen from the level of the 11h rib to the pubic symphysis. The layers of the abdominal wall are divided, the peritoneum opened, and the bowel extravasated. You repack the bowel, lavage the peritoneal cavity, start IV antibiotics and close the wound. The patient is kept in the hospital for 7 days, then sent home with wound care instructions and therapy orders.
4 weeks later he's back in the ER with sharp right lower quadrant pain, vomiting, dehydration and constipation. He reports that he recently had an abrupt loss of appetite and that he has not had a bowel movement in at least 5 days. He further states that he has experienced cramping and colicky pain periodically for the last 2-3 weeks, he has also experienced bouts of nausea. Physical examination reveals the patients right lower quadrant is full, tender, and distended; bowel sounds are hypoactive in left abdomen and upper pelvis. What is going on here and what is the treatment?