A 31-year-old woman is brought in by ambulance to emergency after a 30-minute history of diffusely severe abdominal pain. Vitals are: temperature 99.8F, HR 95, RR 18, BP 150/90. Physical examination shows a soft abdomen without guarding. Bowel sounds are normal. She traveled to India three months ago. Her only medication is propylthiouracil. Serum studies show: WBC 11,000/μL. Serum lactate is elevated. An abdominal x-ray is shown.
What’s the most likely diagnosis?
Arterial embolism
Intestinal obstruction (large bowel)
Intestinal obstruction (small bowel)
Ischemic colitis
Mesenteric thrombosis
Ruptured abdominal aortic aneurysm
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Cut-to-the-chase Answer (0:28):
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HY USMLE Answer (11:35):
