<prompt> A 42-year-old man is hit on the left side of his body by a car and is brought to the emergency department with fractures of the left tenth, eleventh, and twelfth ribs and left tibia and fibula fractures. The patients blood pressure is 12090 mm Hg, pulse rate is 100 bpm, and respiration rate is 24 breaths per minute. He has hematuria and left flank pain. Intravenous lines are inserted. IVP shows no excretion from the left kidney but normal excretion from the right. What would be the next step in management?Exploratory laparotomyCT scan with intravenous contrastArteriographyCystogram  <response>: Arteriography is used to assess possible renal artery injury in these circumstances. It is used if the kidney is not visualized with an IVP or CT a scan. Operative intervention without arteriography is not necessary in a stable patient. Peritoneal lavage is useful in determining the presence of intraperitoneal bleeding; if arteriography shows a need for surgery, peritoneal lavage will not be necessary. 