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A Case Report: A 75-Year-Old Male With Abdominal Pain, Diarrhea, and Hypotension
Marcia Machado1, Daniela Neto2, David Paiva2
1Internal Medicine, Hospital Senhora da Oliveira Guimarães, Guimarães, PRT.
Abstract:
The differential diagnosis of abdominal pain ranges from benign to life-threatening conditions. This case report describes the importance of the differential diagnosis and a faster and more accurate diagnosis. A 75-year-old male presented to the emergency room (ER) with diffuse abdominal pain, associated nausea, vomiting, diarrhea, and a fever of 38.5ºC since the previous day. Medical history included hypertension, dyslipidemia, and obesity. Clinical examination showed hypotension and a distended abdomen with diffuse tenderness in all quadrants. Blood tests revealed a hemoglobin of 11.3 g/dL, and an arterial blood gas test revealed metabolic acidosis and lactate of 8 mmol/L. Contrast-enhanced computed tomography (CT) of the abdomen and pelvis revealed a large aneurysm in the infrarenal aorta with an extension of about 17x8x8 cm and an exuberant mural thrombus. The patient underwent endovascular treatment of the aneurysm; however, he died during surgery.
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