<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:Four days after having been admitted to the hospital for a pulmonary contusion and whiplash injury sustained in a motor vehicle collision, a 66-year-old woman complains of severe pain in her right flank and muscle spasms. She also has nausea with two episodes of vomiting and abdominal bloating. Her pain had previously been well controlled with acetaminophen every 6 hours. She underwent umbilical hernia repair surgery two years ago. She takes sertraline for depression. Her temperature is 36.5C 97.7F, pulse is 99min, respirations are 17min, and blood pressure is 10272 mm Hg. After administration of 0.5 L of crystalloid fluids, blood pressure improves to 11879 mm Hg. Multiple ecchymoses are present over the anterior abdominal wall in a pattern that follows the course of a seatbelt. There are ecchymoses of the flanks bilaterally. Bowel sounds are absent. There is tenderness to palpation in all four quadrants with voluntary guarding. Her hemoglobin is 7.9 gdL, leukocyte count is 8,500mm3, platelet count is 350,000mm3, prothrombin time is 11 seconds, and activated partial thromboplastin time is 33 seconds. An x-ray of the abdomen shows obliteration of the right psoas shadow and uniform distribution of gas in the small bowel, colon, and rectum without air-fluid levels. Which of the following is the most likely explanation for this patients symptoms?? A: Small bowel perforation, B: Intraabdominal adhesions, C: Spinal cord injury, D: Retroperitoneal hemorrhage, E: Acute mesenteric ischemian,  <response>: This is a clinical vignette describing a 66-year-old woman with severe right flank pain, nausea, vomiting, and abdominal bloating 4 days after being admitted for injuries sustained in a motor vehicle collision. Key findings include:- Severe right flank pain and abdominal muscle spasms- Nausea, vomiting, abdominal bloating- History of umbilical hernia repair 2 years ago- Ecchymoses over anterior abdominal wall and flanks bilaterally- Absent bowel sounds, abdominal tenderness and guarding - Hemoglobin 7.9 gdL- Obliteration of right psoas shadow on abdominal X-ray- No air-fluid levels on abdominal X-rayThe history of recent trauma along with ecchymoses over the abdomen and flanks suggest this patient may have sustained intra-abdominal injury. The severe flank pain, abdominal tenderness, muscle guarding, vomiting, and absent bowel sounds point towards an acute intra-abdominal process such as perforation or ischemia. The key imaging finding is obliteration of the right psoas shadow, which suggests retroperitoneal hemorrhage. Of the choices given, retroperitoneal hemorrhage best explains this patients presentation.D: Retroperitoneal hemorrhage 