<prompt> Answer this question truthfullyWhat is the management approach for penetrating trauma cases that present with hemodynamic instability, rebound tenderness, evisceration, blood from NG tube or rectum?  <response>: <reason> Penetrating trauma cases that present with hemodynamic instability, rebound tenderness, evisceration, blood from NG tube or rectum are managed with exploratory laparotomy ex-lap. 