 Goes back to yesterday, the patient went out for dinner with her boyfriend.  The patient after coming home all the family members had some episodes of diarrhea; it is unclear how many times the patient had diarrhea last night.  She was found down on the floor this morning, soiled her bowel movements.  Paramedics were called and the patient was brought to the emergency room.  The patient was in the emergency room noted to be in respiratory failure, was intubated.  The patient was in septic shock with metabolic acidosis and no blood pressure and very rapid heart rate with acute renal failure.  The patient was started on vasopressors.  The patient was started on IV fluids as well as IV antibiotic.  The CT of the abdomen showed ileus versus bowel distention without any actual bowel obstruction or perforation.  A General Surgery consultation was called who did not think the patient was a surgical candidate and needed an acute surgical procedure.  The patient underwent an ultrasound of the abdomen, which did not show any evidence of cholecystitis or cholelithiasis.  The patient was also noted to have acute rhabdomyolysis on the workup in the emergency room.