A 63-year-old man has had insulin dependent diabetes mellitus for
over two decades. The degree of control of his disease is indicated by
the laboratory finding of hemoglobin A1C 10.1%. He has noted episodes of
abdominal pain following meals. These episodes have worsened over the
past year. On physical examination, there are no masses and no
organomegaly of the abdomen, and he has no tenderness to palpation.
Which of the following pathologic findings is most likely to be present
in this man?
A Ruptured aortic aneurysm
B Hepatic infarction
C Mesenteric artery occlusion
D Acute pancreatitis
Correct Answer (C)
Rationale: He has 'abdominal angina' from diminished blood flow to the bowel as a
consequence of severe atherosclerosis. Persons with diabetes mellitus
may have this finding, because all branches of major arteries to the
bowel are affected by atherosclerosis.
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