Abdominal pain following motor vehicle accident

Abstract

A 35-year-old unrestrained male driver is brought in by paramedics following a motor vehicle collision (MVC). There was extensive passenger space intrusion and significant steering wheel deformity. On arrival to the emergency department, the patient is unconscious and unresponsive. His blood pressure is 80/40 mmHg and heart rate is 110/min. He has obvious facial fractures, with blood coming out of his mouth. His pupils are equal, round, and reactive to light. His breathing is shallow and labored. Breath sounds are clear bilaterally. He is not moving, does not open his eyes, and withdraws to pain. His abdomen is non-distended and non-tender to palpation. He has no obvious external sign of trauma on the abdomen. There are no obvious deformities in his extremities.