Approach to abdominal wall and groin masses Quiz: Ace Your Exams
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A 66-year-old man is brought to the emergency department by EMS after developing severe abdominal pain and subsequently passing out. The patient has a past medical history of diabetes mellitus, hypertension and atrial fibrillation for which he takes warfarin. Temperature is 37.0 °C (98.6°F), blood pressure is 75/40 mmHg, respiratory rate is 22/min, pulse is 126/min, and oxygen saturation is 97% on room air. On physical examination, the patient is pale and diaphoretic and unable to provide a clinical history, but he is responsive to painful stimuli. Abdominal examination shows abdominal tenderness and guarding; and a tender, nonpulsatile palpable abdominal mass on the right side of the abdomen above the umbilicus with overlying ecchymoses. It is unclear if it crosses the midline. Hemoglobin is 10.6 g/dl at presentation and decreases to 8.9 g/dl after imaging is performed. Which of the following complications is most likely to occur without prompt intervention?
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