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Acute mesenteric ischaemia — MCCQE Part 1 MCQ

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HardAbdominal PainAcute mesenteric ischaemiaMCCQE Part 1

A 68-year-old man with AF (not anticoagulated) has 6-hour severe diffuse abdominal pain. Pain out of proportion to examination. Abdomen soft, minimal tenderness. Lactate 5.2. Most likely diagnosis?

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Correct answer: C — Acute mesenteric ischaemia

Classic triad: severe pain out of proportion to exam + rapid deterioration + embolic source (AF without anticoagulation). CT angiography diagnostic. Emergent: anticoagulation + revascularisation/resection.

Reference: Canadian Vascular Surgery Guidelines