Published 22 July 2009, doi:10.1136/bmj.b2302
Cite this as: BMJ 2009;339:b2302

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A surgical emergency

Paolo G Sorelli, ST4 general surgery, Daniel Thomas, registrar general surgery, Happy Hoque, consultant breast and general surgeon

1 Department of Surgery, Queen Mary’s Hospital, Sidcup DA14 6LT

P Sorelli, London SW6 5EE paolosorelli@hotmail.com

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

A 91 year old man presented with acute onset right sided abdominal pain that radiated to his right groin. He reported having had an urge to urinate and had subsequently collapsed on his way to the toilet. He had no back pain or incontinence of urine or faeces. His medical history included controlled hypertension, but he was otherwise fit and well and living independently.

On examination, the patient had a normal temperature but was tachycardic, with a pulse rate of 110 beats/min. His blood pressure was 85/50 mm Hg, which improved to 110/70 mm Hg after fluid resuscitation with 2 l of crystalloid solution. His chest was clear. Examination of his abdomen revealed a tender and non-pulsatile 15x10 cm mass in the right iliac fossa that extended to the groin. There were strong femoral pulses bilaterally.

Chest radiograph did not show any evidence of free intraperitoneal air, suggestive . . . [Full text of this article]


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