Unusual computed tomography findings in a patient presenting with acute abdominal pain

doi:10.1136/bmj.b3192

Published 19 August 2009, doi:10.1136/bmj.b3192
Cite this as: BMJ 2009;339:b3192

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Unusual computed tomography findings in a patient presenting with acute abdominal pain

James K K Chan, senior house officer in surgery, Richard Lovegrove, specialist registrar in surgery, Matt Dunckley, senior house officer in surgery, Eric K Woo, consultant radiologist, Marwan Farouk, consultant surgeon

¹ Stoke Mandeville Hospital, Buckinghamshire NHS Trust, Aylesbury, Bucks HP21 8AL

Correspondence to: J K K Chan jackichan17@hotmail.com

The first 150 words of the full text of this article appear below.

An 84 year old woman presented with acute, diffuse, colickyabdominal pain associated with intermittent vomiting, and hada six week background of general malaise and weight loss. Hermedical history included atrial fibrillation, peripheral vasculardisease, transitional cell carcinoma of the bladder, pulmonaryembolism, and chronic obstructive pulmonary disease.

At initial assessment, the patient’s temperature was 36.7°C, pulse 112 beats/min irregular, and blood pressure 91/71mm Hg. Her respiratory rate was 20 breaths/min and her bloodoxygen saturation was 98% on 15 litres oxygen.

On examination, the patient was dehydrated but alert and oriented.Her abdomen was rigid with absent bowel sounds. Digital rectalexamination was tender for the patient and there were firm stoolsin the rectum. Both feet were pale, cold, and cyanosed witha capillary refill time of more than 5 seconds.

The patient’s arterial blood gas results on 10 litresoxygen were as follows: . . . [Full text of this article]

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