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- suspect in any male over 55 years with back pain
- more common than urinary stones in this age group
Differential
History
- sudden onset
- upper abdominal/periumbilical pain
- radiating to back
Examination
- elderly
- shocked
- abdominal distension
- tender, pulsatile mass
Treatment
- fluids
- as much as possible through two large cannulae
- bloods
- FBC
- U&E
- Amylase
- Blood sugar
- clotting
- ABGs
- oxygen
- Blood
- inform theatre
- antibiotics
- nasogastric tube once anaesthetised
- urinary catheter
- on table preparation
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