A 35-year-old woman with no past medical history presents to the emergency department with sudden-onset, severe, tearing abdominal pain radiating to her back. She reports feeling faint. Vital signs: BP 88/52 mmHg, HR 118 bpm, RR 22/min, temperature 37.1°C. Physical examination reveals a pulsatile abdominal mass and left flank ecchymosis. Bedside ultrasound shows a 5.3 cm anterior lumbar mass with turbulent color flow on Doppler. Which of the following is the most likely diagnosis?
- A)Ruptured abdominal aortic aneurysmGABARITO
- B)Acute aortic dissection with contained rupture
- C)Splenic artery pseudoaneurysm with hemorrhage
- D)Renal infarction with retroperitoneal hematoma
- E)Acute pancreatitis with hemorrhagic necrosis
Explicação
The presentation is classic for ruptured abdominal aortic aneurysm (rAAA): sudden-onset tearing abdominal pain with radiation to back, hypotension, tachycardia, pulsatile abdominal mass, and flank ecchymosis (Cullen sign variant). Ultrasound findings of a >5 c... Ver explicação completa e trilha adaptativa →