Snapshot A 30-year-old male victim of an automotive hit-and-run incident presents to the ED. Initial primary survey reveals no airway obstruction and good ventilation. Two large bore IV's are inserted and blood pressure is 95/60 mmHg, pulse is 95/min, respirations are 18/min, and SaO2 is 95% on room air. One liter of Lactated Ringer's is started. Secondary survey reveals no obvious source of blood loss. Despite this and fluid resuscitation, the patient's blood pressure drops to 85/55 mmHg. A FAST ultrasound exam reveals fluid surrounding the spleen and in Morrison's pouch. The patient is rushed to the OR for an exploratory laparotomy. Introduction Overview login to view 2 more bullets Epidemiology Incidence login to view 10 more bullets Demographics login to view 2 more bullets Location login to view 4 more bullets Risk factors login to view 3 more bullets ETIOLOGY Pathogenesis login to view 7 more bullets Presentation History login to view 13 more bullets Symptoms login to view 1 more bullet Physical exam login to view 11 more bullets Imaging Radiograph login to view 4 more bullets FAST ultrasound login to view 5 more bullets Diagnostic peritoneal lavage (DPL) login to view 6 more bullets CT scan login to view 5 more bullets Studies Serum labs login to view 12 more bullets Differential Cardiac trauma login to view 3 more bullets Pulmonary trauma login to view 2 more bullets Management Medical login to view 7 more bullets Surgical login to view 42 more bullets Complications Surgical wound infection login to view 1 more bullet Shock login to view 2 more bullets