q14 - kola

[ArchivalUser]

An 18 year old male was driving 90 MPH on the highway when he loses control of his vehicle and crashes into oncoming traffic. His airbag deploys and saves his life, however he suffers significant blunt abdominal trauma as well as a few broken ribs. He is brought to the ED and complains of abdominal pain that radiates to the left scapula. He is tachycardic and his BP is 68/40. On exam, he has skin pallor, feels cool to the touch and appears to be in severe pain. He has diffuse abdominal tenderness with involuntary guarding, and positive Kehr's sign. What is most likely responsible for his symptoms?

1. Kidney laceration
2. Small bowel injury
3. Splenic laceration
4. Splenic contusion
5. Liver laceration
6. Liver contusion

[ArchivalUser]

3...

[ArchivalUser]

right

[ArchivalUser]

clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of right upper quadrant abdominal tenderness.

Left shoulder tenderness may also be present as a result of subdiaphragmatic nerve root irritation with referred pain