A 56 year old obese male is rushed to the ER via ambulance. The EMS team reports he was
found non- responsive and in shock. Additionally, they note he has a stiff rigid abdomen and can
feel a large lump near the midline. Upon questioning, his wife explained that her husband was
complaining of incredible acute pain in his abdomen and back. When she returned from calling
911 she found him pale, clammy and confused. You are asked to prepare the OR for an
emergency surgery… Please indicate the following: 1. List the patient’s most likely pathology
Aortic aneurysm
Based on the given information, the patient's most likely pathology is a ruptured abdominal aortic aneurysm (AAA).
Based on the given information, the patient's most likely pathology is an abdominal aortic aneurysm (AAA) that has ruptured.
To arrive at this conclusion, several clinical findings are suggestive of an AAA rupture:
1. Age and gender: The patient is a 56-year-old male, and AAA is more common in males over 60 years of age.
2. Obesity: Obesity is a risk factor for AAA development.
3. Non-responsiveness and shock: These symptoms could be due to severe internal bleeding, which is likely to occur when an AAA ruptures.
4. Stiff rigid abdomen: This is a sign of a potentially life-threatening condition, indicating underlying organ damage due to the rupture.
5. Large lump near the midline: Feeling a large lump near the midline could indicate the presence of a pulsatile mass, which is a characteristic finding in AAA.
6. Acute pain in the abdomen and back: Severe and sudden-onset abdominal and back pain are common symptoms of an AAA rupture.
7. Pale, clammy skin, and confusion: These symptoms indicate poor blood perfusion due to hypovolemic shock caused by internal bleeding.
Considering all these factors, the most likely pathology in this case is an abdominal aortic aneurysm (AAA) rupture. AAA is a potentially life-threatening condition that requires immediate surgical intervention.