Sudden Severe Diffuse Abdominal in Medicine / Internal Medicine — 75yo Woman | Gastroenterology | SMLE Q#17516

SMLE Question #17516

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-IM-GI-AMI-001

Last updated: February 2026
A 75-year-old woman with chronic atrial fibrillation and intermittent nonadherence to anticoagulation presents with sudden severe diffuse abdominal pain for 3 hours. She describes pain out of proportion to examination and has had unintentional weight loss. The abdomen is soft with mild diffuse tenderness, no guarding or rigidity, and decreased bowel sounds; peripheral pulses are palpable. Acute mesenteric ischemia is suspected. What is the most appropriate initial investigation to confirm the diagnosis?

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