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Mesenteric ischaemia

Terms in this set (2)

The medical emergency team (MET) is called to see a 49 year-old male hospital inpatient who has become hypotensive and is screaming in pain.

The patient, who was initially admitted for new-onset atrial fibrillation and vomiting, is found by the MET to be severely unwell. His BP is 71 / 43. On examination, his abdomen is soft despite being diffusely painful. His underwear is found to be soiled with bloody stool.

An ABG shows a metabolic acidosis with a sodium of 149, a lactate of 9.3, and a base excess of -8.

What is the most likely diagnosis in this case?

A. Acute mesenteric ischaemia
B. Perforated bowel
C. Acute campylobacter gastroenteritis
D. Exacerbation of ulcerative colitis
E. Acute ischaemic colitis

A. Acute mesenteric ischaemia

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