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What is A 30-year-old restrained driver was involved in a motor-vehicle crash. He is hemodynamically stable and has a large seat belt sign on the abdomen. His abdomen is tender to palpation. In this patient one should be most concerned about: and explain in detail?
While all the injuries listed are potential problems in this patient, the most severe is blunt hollow viscus injury. A delay in diagnosis beyond 12 hours is associated with increased morbidity and mortality. There may be very few physical signs of a viscus perforation and CT findings may be subtle and not definitive. A seat belt sign across the abdomen should raise suspicion of this injury and prompt an aggressive pursuit of diagnosis by serial examination and a consideration of a peritoneal lavage or repeat CT scan.