A bowel obstruction, a suspected malignancy, and multiple comorbidities — this case had all the makings of a clinical storm. In this episode of Clinical Adventurer, we walk through the complex hospital course of a 72-year-old male whose sigmoid stricture led to large bowel obstruction, feculent peritonitis, and septic shock. From emergent surgeries and ICU-level vasopressor support to managing cardiac instability and thrombocytopenia, we unpack the critical decision points, pathophysiology, and bedside nursing priorities that shaped his care. All patient identifiers have been changed. If you’re ready for a deep dive into surgical complications, sepsis physiology, and real-world nursing strategy, this is one you won’t want to miss.