Overly Traumatic: A Teenager Elbowed in the Stomach
A 17 yo healthy M presents with abdominal pain and a syncopal episode several hours after getting elbowed in the stomach at a soccer game.
PMH: Intermittent asthma
ROS: Sore throat, cough and fatigue x 1 week.
VS: T 98.3 °F | HR 90 | BP 129/60 | RR 16 | SpO2 100%
Pale but comfortable and alert. Abdomen diffusely tender, guarding in the upper quadrants. Exam otherwise unremarkable.
RUQ: Free fluid in Morrison’s pouch & at the tip of the liver
LUQ: Free fluid in splenorenal recess & bowel floating in free fluid
Transverse Bladder: Large amount of fluid & clotted blood anterior to the bladder
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