A 75-year-old lady presents with a 2-hour history of sudden-onset severe abdominal pain and per rectum bleeding. Other than a stroke 2 years ago she keeps well. She has been on aspirin and ramipril since her stroke and takes digoxin for an irregular heart rhythm. On examination she is very distressed; her abdomen is soft with no evidence of peritonism. Bowel sounds are audible. An arterial blood gas shows a metabolic acidosis. What is the likeliest diagnosis? 1_Ruptured aortic aneurysm 2_Acute small bowel ischaemia 3_Perforated peptic ulcer 4_Diverticulitis 5_Irritable bowel syndrome
Posted on: Sun, 23 Nov 2014 23:14:14 +0000
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