Abdominal aortic aneurysm rupture
An 73-year-old woman calls EMS and complains of sudden worsening of three days lasting abdominal pain. Today she vomited and she feels faint. The pain's getting worse with irradiation into tower back. The patient is brought by the ambulance to the emergency room - here she is conscious, clammy, hypotensive, afebrile, with inserted venous catether of G18 diameter. The abdomen is distended, painful, with impaired peristalsis. What tests will you perform in the ED?
Examination
Past medical history: hypertension treated by drugs, Type 2 diabetes treated with oral antidiabetics, chronic bronchial asthma. Today the patient took 4 pills of Ibuprofen 400 mg.
Physical examination: the abdomen is diffusely painfull, distended, with impaired peristalsis, pulsating resistance