17th July 2020

A 54-year-old woman presents to the emergency department with acute onset generalised abdominal pain

A 54-year-old woman presents to the emergency department with acute onset generalised abdominal pain. She rated the pain as 9/10 and the pain is constantly there. She has been feeling nauseous and has vomited twice in the ambulance. She was recently diagnosed with breast cancer. She also has a past history of AF and hypertension. On examination, she has a generalised abdominal guarding. Her observations are temperature 38.5ºC, pulse 115 bpm, respiratory rate 23/min and BP 138/89 mmHg. ABG shows a metabolic acidosis picture. You think this is likely to be an acute mesenteric ischaemia.

What is the definitive management for this woman?

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