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Acute mesenteric ischemia — ABEM Board MCQ

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HardGI/Abdominal emergenciesAcute mesenteric ischemiaABEM Board

A 74-year-old man arrives as ESI 2 with abrupt abdominal pain out of proportion to examination. BP 104/66, HR 118, lactate is 6.1 mmol/L, WBC 18,000/mcL, and he has atrial fibrillation. Which of the following is the most likely diagnosis?

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Correct answer: C — Acute mesenteric ischemia

Pain out of proportion, lactic acidosis, leukocytosis, and embolic risk from atrial fibrillation suggest acute mesenteric ischemia.

Reference: World Society of Emergency Surgery guideline: Acute Mesenteric Ischemia