Welcome to this month’s What’s Your Diagnosis Challenge!
But before we begin, check to see if you got the previous case on Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence correct.
Case Presentation: Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department Â
A 55-year-old woman presents via EMS with vomiting and diarrhea in the setting of new, severe abdominal pain for the past 30 minutes…Â
- The patient states that she was previously diagnosed with atrial fibrillation, but she never established care due to concerns about the cost of anticoagulation medication.
- Her temperature is 37ËšC; blood pressure, 156/90 mm Hg; heart rate, 110 beats/min; respiratory rate, 20 breaths/min; and oxygen saturation, 96% on room air.
- On physical examination, you note that despite the patient reporting severe abdominal pain, she does not seem to have any significant tenderness or guarding. Her laboratory test results are notable for mild acute kidney injury but no leukocytosis or lactic acidosis.
- You wonder whether these laboratory tests have sufficiently ruled out acute mesenteric ischemia. If not, is it still reasonable to move forward with CT imaging?
Make your best guess, and check back next month to find out the correct answer!
USACS subscribers can log in or renew here.
