MedBugs: SAQ #26

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Case: Mesenteric ischemia

A 78-year-old male presents with 16 hours of severe colicky abdominal pain and diarrhoea. Following your initial assessment, you are concerned he has mesenteric ischaemia.

1. List (4) historical features and (4) examination features that would be strongly suggestive of the diagnosis 8 marks

His blood results and VBG show a WCC of 16,000 with a pH of 7.25, HC03 15, Lactate 5. You decide to order an abdominal X-ray whilst waiting for the CT scanner.

2. List (4) findings that may be present 4 marks

He subsequently undergoes a CT angiogram which confirms acute arterial ischaemia.

3. Outline your immediate management priorities in the ED 6 marks

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Case: Mesenteric ischemia

1. List (4) historical features and (4) examination features that would be strongly suggestive of the diagnosis 8 marks

2. List (4) findings that may be present 4 marks

3. Outline your immediate management priorities in the ED 6 marks

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