A 65-year-old male with known atrial fibrillation presents with sudden onset of severe abdominal pain. He has a rigid abdomen with absent bowel sounds...

Question

A 65-year-old male with known atrial fibrillation presents with sudden onset of severe abdominal pain. He has a rigid abdomen with absent bowel sounds. His lactate is 8.5 mmol/L on point-of-care testing. What does the severely elevated lactate indicate in this clinical context?

Accepted Answer

Tissue ischaemia from acute mesenteric arterial occlusion - the elevated lactate reflects anaerobic metabolism in ischaemic bowel; this is a surgical emergency with mortality exceeding 60%

Answer

The lactate is a normal finding in abdominal pain

Answer

The lactate indicates the patient has diabetes

Answer

Lactate is only relevant in cardiac arrest, not abdominal emergencies

Answer

The elevated lactate indicates dehydration only

uk-dipimc MCQ (SBA): Lactate in Mesenteric Ischaemia

A 65-year-old male with known atrial fibrillation presents with sudden onset of severe abdominal pain. He has a rigid abdomen with absent bowel sounds. His lactate is 8.5 mmol/L on point-of-care testing. What does the severely elevated lactate indicate in this clinical context?