Acute mesenteric ischaemia: A case of expedited diagnosis and management using point-of-care ultrasound

We describe the case of a 28-year-old male who presented to an urban Ethiopian emergency centre with three days of vomiting, bloody diarrhoea, and abdominal pain. He collapsed in triage with weak pulses and an undetectable blood pressure. Point-of-care ultrasound revealed a hyperechoic, mobile mass in the left ventricle of the heart. Small bowel dilation and thickening was visualised throughout the abdomen. Mesenteric ischaemia was rapidly identified as the working diagnosis, prompting early surgical consultation and aggressive, goal-directed resuscitation.DiscussionShort of elucidating a definitive diagnosis, ultrasound narrowed the focus of an undifferentiated presentation and supported mobilisation for exploratory laparotomy. Ultimately, this circumvented several hours of time which is conventionally required to obtain computed tomography at this institution. As demonstrated in this case, point-of-care ultrasound can be life-saving in resource-limited settings where acquisition time for definitive imaging is often prohibitive.
Source: African Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research