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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 54-year-old man presents to the emergency department with a severe diffuse abdominal pain, nausea, and vomiting. The patient states that the pain acute onset approximately 3 hours ago and has not improved. He denies any fever or chills. His last bowel movement was yesterday morning which was normal. The patient has a history of hypertension and infectious endocarditis 7 years ago. Current medications are hydrochlorothiazide and lisinopril. Patient denies any history of gastrointestinal disease although notes he frequently has abdominal discomfort after meals. Vital signs are as follows: blood pressure 150/90 mm Hg, heart rate 87/min, respiratory rate 22/min, and temperature of 37.4℃ (99.3℉). On physical examination, the patient is agitated and appears to be in significant pain. Lungs are clear to auscultation. The cardiac exam is significant for a 2/6 pansystolic grade murmur best heard at the apex and the presence of a pulse deficit. The abdomen is soft and nondistended, but there is tenderness to palpation in the periumbilical region. No rebound or guarding. Bowel sounds are present.
Laboratory tests show the following results:
RBC count 4.4 x 106/mm3
Hemoglobin 12.9 g/dL
Hematocrit 35%
Leukocyte count 12,400/mm3
Platelet count 312,000/mm3
Serum:  
Na+ 140 mEq/L
Cl- 103 mEq/L
K+ 4.4 mEq/L
HCO3 20 mEq/L
Base deficit -4
BUN 11 mg/dL
Glucose 97 mg/dL
Creatinine 1.1 mg/dL
Ca2+ 10.7 mg/dL
Lactate 7.6 mmol/L
Amylase 240 U/L
Stool guaiac negative
EKG is significant for findings consistent with atrial fibrillation and left ventricular hypertrophy. Which of the following findings is most likely to be seen on this patient’s contrast CT of the abdomen?
assistant
Lack of enhancement of the branches of the superior mesenteric artery