More Tummy Pain

A 72 year old woman presents with severe, generalized abdominal pain for 1 hour, in association with nausea, vomiting and watery diarrhea.

Her medical history is significant only for well controlled hypertension for 5 years; she is currently on therapy with losartan only.

A full blood count is significant for a leukocyte count of 15,000/mm3 with 90% neutrophils, while serial ECGs are only significant for atrial fibrillation.

A chest x-ray, serum amylase, and serum lipase levels are found to be normal.

Selecionar Exames Relevantes
Abdominal X-Ray

Realizados

The abdominal x-ray appears normal.
Ultrasound Abdomen

Realizados

The ultrasound scan of the abdomen appears normal.
CT + CTA Abdomen

Realizados

The CT scan shows distension of the small intestine and proximal colon; CT angiography reveals occlusion of the superior mesenteric artery (SMA) close to its origin by an embolus.
Colonoscopy

Realizados

You realize that colonoscopy might waste valuable time.

Selecionar Manejo Relevante
Systemic Thrombolytics
Anticoagulation
NG Tube
IV Antibiotics