Would you proceed with urgent mesenteric CTA when the patient has acute kidney injury?

Instruction: Make a specific imaging decision and explain why the kidney risk does or does not justify delay in this patient.

Context: A 76-year-old with atrial fibrillation has sudden severe abdominal pain disproportionate to the initial examination. The surgical team suspects acute mesenteric ischemia. The patient has chronic kidney disease and a creatinine that has risen substantially today, but is stable enough for CT. There is no prior severe contrast reaction. CTA is available now; MRI would require an overnight wait.

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I would recommend urgent CT angiography of the abdomen and pelvis with intravenous contrast using our mesenteric ischemia protocol. The immediate problem is possible threatened bowel...

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