Acute mesenteric ischemia Quiz: Ace Your Exams
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A 75-year-old man presents to the emergency department with a sudden onset of severe abdominal pain that began six hours ago. He has a history of hypertension and hyperlipidemia. Temperature is 37.5°C (99.5°F), blood pressure is 94/62 mmHg, pulse is 122/min and irregular, respiratory rate is 22/min, and oxygen saturation is 98% on room air. On examination, his abdomen is soft and mildly distended, with diffuse rebound tenderness to palpation. Laboratory findings are significant for leukocytosis and a lactate of 5.4 mmol/L (0-2 mMol/L). ECG is significant for atrial fibrillation with rapid ventricular response. IV fluids and broad-spectrum antibiotics are initiated. Abdominal x-ray reveals findings consistent with pneumatosis intestinalis within the ascending colonic bowel wall. Which of the following is the most appropriate next step in management?
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