Question

A 65-year-old gentleman presents with acute onset severe abdominal pain. The pain is described as "diffuse" without localization and constant. The patient states that he has had nausea and vomitting with this episode. Physical examination shows absent bowel sounds, mild abdominal distention, and pain that is disproportionate to the exam findings. What is the diagnosis?

Answer 1

The diagnosis for the 65-year-old gentleman is mesenteric ischemia, which is characterized by reduced blood supply to the intestines. Symptoms include severe abdominal pain, nausea, vomiting, and absent bowel sounds. Prompt medical attention is essential.

Step-by-step explanation:

The Diagnosis

The diagnosis for the 65-year-old gentleman is mesenteric ischemia. Mesenteric ischemia is a condition where the blood supply to the intestines is reduced, leading to severe abdominal pain. The symptoms described, including diffuse pain, nausea, vomiting, absent bowel sounds, and disproportionate pain to the examination findings, are consistent with this diagnosis.

Possible Causes

Mesenteric ischemia can be caused by several factors, such as arterial embolism, arterial thrombosis, or mesenteric venous thrombosis. These conditions can lead to reduced blood flow to the intestines, resulting in ischemia.

Signs and Symptoms

In addition to the symptoms mentioned, other signs and symptoms of mesenteric ischemia may include bloody stools, fever, and signs of peritonitis if the condition progresses. Prompt medical attention is crucial for proper diagnosis and treatment.