26th April 2024

A 68-year-old woman with a history of hypertension and hypercholesterolemia presents with sudden onset of severe abdominal pain that began three hours ago.

A 68-year-old woman with a history of hypertension and hypercholesterolemia presents with sudden onset of severe abdominal pain that began three hours ago. The pain is diffuse, sharp, and does not improve with changes in position. She reports a feeling of bloating and has not passed gas or had a bowel movement since the pain began. She denies any recent changes in her diet or bowel habits. Her temperature is 37.4°C, and her pulse rate is 95 bpm. On examination, her abdomen is distended and diffusely tender, but there is no rebound tenderness. Bowel sounds are decreased.

Investigations:

Blood tests show elevated white blood cell count and lactate.

Which is the most likely diagnosis?