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A 60-year-old man with a history of chronic back pain presents to the emergency department with abdominal pain. He states his back pain has been worsening recently requiring more pain medications. His temperature is 97.6°F (36.4°C), blood pressure is 122/80 mmHg, pulse is 120/min, respirations are 12/min, and oxygen saturation is 98% on room air. The patient is laying still on his back and is moaning in pain. There is notable tenderness in all quadrants with rebound tenderness. The patient's heart rate is 90/min after receiving hydromorphone. A radiograph is performed as seen in Figure A. Which of the following is the most likely diagnosis?
Peptic ulcer disease
Ruptured abdominal aortic aneurysm
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A 24-year-old male is brought in by fire rescue after being the restrained driver in a motor vehicle accident. There was a prolonged extraction. At the scene, the patient was GCS 13. The patient was boarded and transported. In the trauma bay, vitals are T 97.2 F, HR 132 bpm, BP 145/90 mmHG, RR 22 rpm, and O2 Sat 100%. ABCs are intact with a GCS of 15, and on secondary survey you note the following (Figure F). FAST exam is positive at Morrison's pouch. Abdominal exam shows exquisite tenderness to palpation with rebound and guarding. Which of the following radiographs is most likely to be present in this patient?