1st April 2022

A 68-year-old male presents to the emergency department complaining of severe generalised abdominal pain

A 68-year-old male presents to the emergency department complaining of severe generalised abdominal pain, which hasn’t improved despite morphine. The pain came on suddenly 3 hours ago after eating Thai curry and he reports that he has never experienced this type of pain before. He has a past medical history of hypertension, Type 2 diabetes and atrial fibrillation. He currently takes warfarin, metformin, glicazide and amlodipine. He smokes 20 cigarettes per day and drinks 12 units of alcohol per week. His bloods are as follow:

• Na+: 140 mmol/l (135 – 145)
• K+: 5.0 mmol/l (3.5 – 5.0)
• HCO₃: 26 mmol/l (22 – 28)
• Urea: 7.1 mmol/l (2.0 – 7.0)
• Creatinine: 150 µmol/l (55 – 120)
• Lactate: 3 mmol/l (<2)

The patient is haemodynamically stable. What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.