Case 5
An 85 y/o man presents to ED complaining of a 4 hour history of severe, 10/10, generalised abdominal pain with associated vomiting. He has a history of ischaemic heart disease and atrial fibrillation (AF). He is in rapid AF at 135bpm, BP is 160/90, Sats of 96% on room air, RR is 28 and he is apyrexic.
His VBG demonstrates a metabolic acidosis with a high lactate and a low pH.
Question 1
What is the most likey diagnosis?
Question 2
What investigations would you organise for this patient?
Question 3
What is the ED management and ultimate disposition for this patient?