A 33year-old female with diabetes mellitus type 2 and stage four chronic kidney disease presented to the emergency department with altered mental status and severe abdominal pain. Three months prior, she underwent an emergent ileocolectomy for ischemic colitis, presumably due to septic embolus from right sided endocarditis. Other pertinent history included an abdominal debridement for calciphylaxis deposits. On examination, she was hypotensive with a blood pressure of 70/52mmHg, pulse of 102 beats per minute, respiratory rate of 15/min, and a temperature of 36°C.
