Acute mesenteric ischemia Quiz: Ace Your Exams
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A 68-year-old man presents to the emergency department with sudden-onset, severe abdominal pain that began 4 hours ago. He has a history of hypertension and hyperlipidemia. On examination, his abdomen is soft, and minimally distended, with mild tenderness to palpation. Temperature is 36.9°C (98.4°F), blood pressure is 98/65 mmHg, pulse is 115/min and irregular, respiratory rate is 20/min, and oxygen saturation is 98% on room air. Laboratory findings are significant for leukocytosis and a lactate of 3.2 mmol/L. ECG is significant for atrial fibrillation with rapid ventricular response. CT angiography of the abdomen and pelvis shows an occlusion of the superior mesenteric artery by an oval-shaped thrombus. IV fluids and broad-spectrum antibiotics are initiated. Which of the following is the best next step in management of this patient?
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