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Acute Mesenteric Ischemia

  • Jonathan S. Refson
  • George Geroulakos
Chapter

Case Report

A 78-year-old woman presented to the emergency department with a 12-h history of sudden-onset abdominal pain. She had vomited after the pain started, and she had also had two episodes of diarrhoea. Until this time, she had been well, although she was known to be in atrial fibrillation and took digoxin 125 mg daily.

On examination, she was distressed and obviously in pain. Baseline observations revealed a pulse of 110 bpm, irregularly irregular, blood pressure of 95/60 mmHg, respiratory rate of 28 breaths/min, and temperature of 37.3 °C. Her chest was clear, heart sounds were normal (irregular rhythm), and the jugular venous pressure was not elevated. Abdominal examination was unremarkable, with a soft abdomen and minimal tenderness despite severe pain, and normal bowel sounds.

The investigations shown in Table 29.1 were performed by the admitting surgeon.
Table 29.1

Investigations performed by the admitting surgeon updated

Investigation

Finding

Urinalysis

Biochemistry

No...

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Vascular SurgeryPrincess Alexandra HospitalHarlowUK
  2. 2.Vascular Surgery, Division of Surgery and CancerImperial CollegeLondonUK
  3. 3.Department of Vascular SurgeryNational and Kapodistrian University of AthensAthensGreece

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