A 28-year-old unrestrained driver involved in a high-speed motor vehicle crash presents with left upper quadrant pain and left shoulder pain (Kehr sign). Blood pressure is 85/55 mmHg and pulse is 125 bpm. What intra-abdominal organ is most likely injured?
Answer and explanation
Correct answer: D. Spleen (splenic laceration with hemoperitoneum)
- Step 1: The spleen is the most frequently injured solid abdominal organ in blunt trauma.
- Step 2: Blood irritating the left hemidiaphragm refers pain to the left shoulder via the phrenic nerve (C3-C5 dermatome, Kehr sign).
- Step 3: Hypotension in blunt trauma warrants FAST examination and immediate resuscitation.
Answer
Spleen (splenic laceration with hemoperitoneum).
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