Intestinal Ischemia / Thrombosis

Suspect in at-risk patients with new abdominal pain:
  • older age, with advanced cardiovascular disease
  • heart failure
  • embolic risks:   A Fib, prosthetic valves
  • thrombotic risks: portal hypertension, hypercoagulable states (or fam. Hx thereof)
Diagnosis:    Difficult. 
  • Angiography
  • phased-CT (maybe)
Send to ER:
  • At-risk patient with sudden onset severe abdominal pain disproportionate to physical findings
  • Nausea / Vomiting is common
  • Forceful defecation: uncommon, but highly specific

See posting Abdominal Pain – 3.