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Acute mesenteric ischaemia — RCPSC EM MCQ

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HardGI/Abdominal emergenciesAcute mesenteric ischaemiaRCPSC EM

A 76-year-old with atrial fibrillation has sudden severe abdominal pain out of proportion to examination. BP is 104/64 mmHg, lactate is 5.2 mmol/L, WBC is 19 x 10^9/L, and abdominal radiograph is non-specific. What is the most appropriate investigation?

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

CT angiography of the abdomen and pelvis is correct: the clues indicate Acute mesenteric ischaemia and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian vascular abdominal emergency practice