gs ▁usage ▁and ▁ble eding ▁dis orders . ▁Visual ▁ins pection ▁for ▁signs ▁of ▁external ▁tra uma ▁such ▁as ▁ab ras ions , ▁la cer ations , ▁cont us ions , ▁and ▁classic ▁seat b elt ▁sign ▁on ▁the ▁ab d omen ▁is ▁helpful . ▁The ▁absence ▁of ▁external ▁visual ▁find ings ▁does ▁not ▁exclude ▁int ra - ab dom inal ▁path ology , ▁as ▁up ▁to ▁ 2 0 % ▁of ▁patients ▁with ▁int ra - ab dom inal ▁injury ▁may ▁not ▁display ▁these ▁find ings ▁upon ▁initial ▁exam ination . ▁Also , ▁exam ination ▁on ▁arrival ▁may ▁not ▁reve al ▁severe ▁tend ern ess , ▁rig id ity , ▁or ▁ab dom inal ▁dist ention ▁in ▁spite ▁of ▁ru pt ure . ▁Phys ical ▁exam ination ▁may ▁also ▁be ▁limited ▁in ▁a ▁patient ▁with ▁alter ed ▁mental ▁status ▁or ▁dist ract ing ▁inj uries . ▁Therefore , ▁the ▁physical ▁exam ▁alone ▁is ▁not ▁always ▁sensitive ▁when ▁evalu ating ▁a ▁patient ▁with ▁a ▁spl en ic ▁ru pt ure . ▁ ▁Reference ▁ ▁Category : S ple en ▁( an atom y ) <0x0A> </s> ▁Cas par ▁But z ▁( Oct ober ▁ 2 3 , ▁ 1 8 2 5 ▁– ▁October ▁ 1 9 , ▁ 1 8 8 5 ) ▁was ▁a ▁German ▁American ▁journalist ▁and ▁politician ▁who ▁served ▁as ▁a ▁member ▁of ▁the ▁Illinois ▁House ▁of ▁Representatives ▁from ▁ 1 8 5 8 ▁to ▁ 1 8 6 0 ▁and ▁as ▁City ▁C ler k ▁of ▁Chicago ▁from