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Suspect acute mesenteric ischemia in any older patient with risk factors (atrial fibrillation) who presents with ACUTE onset abdominal pain with a paucity of physical findings. And, don't be fooled by "gut emptying" symptoms of vomiting and diarrhea. If you think grandma has acute onset gastroenteritis, think again. The only way to pick up this diagnosis more is to think about it more often. (sent on behalf of Dr. Rob Rogers)