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Mesenteric ischemia — ABEM Board MCQ

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HardGI/Abdominal emergenciesMesenteric ischemiaABEM Board

A 78-year-old woman with atrial fibrillation arrives with abrupt severe abdominal pain. Triage acuity is ESI 2; BP 138/76 mm Hg, HR 118/min irregular. Her abdomen is soft with mild tenderness, but lactate is 5.2 mmol/L. Stool is guaiac positive. Which of the following is the most appropriate imaging study?

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Correct answer: B — CT angiography of the abdomen and pelvis

Suspected acute mesenteric ischemia is best evaluated with urgent CT angiography when the patient is stable enough for imaging.

Reference: World Society of Emergency Surgery acute mesenteric ischemia guideline