skip to main content

Acute superior mesenteric artery embolism — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardAcute GI PresentationsAcute superior mesenteric artery embolismSCE Acute Medicine

A 67-year-old man with atrial fibrillation presents with sudden severe abdominal pain that seems disproportionate to examination. Lactate is 6.8 mmol/L, WCC 19 x 10^9/L and CT abdomen with arterial phase contrast shows occlusion of the superior mesenteric artery. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Urgent vascular surgery and interventional radiology referral for revascularisation

SMA occlusion with lactic acidosis is acute mesenteric ischaemia requiring urgent revascularisation and surgical assessment for bowel viability. Colonoscopy is not the diagnostic or therapeutic priority in arterial occlusion. Symptomatic improvement after opioids does not indicate resolution. The classic clue is severe pain out of proportion to early abdominal signs.

Reference: ESVS mesenteric ischaemia guideline, NICE CKS abdominal pain