Review Question - QID 210536

A 24-year-old man presents to the emergency department after a motor vehicle accident. He was the unrestrained driver in a head-on collision. The patient was ejected from the front seat and found outside his car. In the trauma bay, the patient is started on IV fluids, blood products, and vasopressors. A FAST exam and chest radiograph are performed as shown in Figure A, and multiple lacerations are repaired. After the initial resuscitation, his temperature is 98.4°F (36.9°C), blood pressure is 107/58 mmHg, pulse is 122/min, respirations are 22/min, and oxygen saturation is 98% on room air. The patient is conscious and complains of severe left shoulder pain and shortness of breath. He also vomits several times. Which of the following is the most likely diagnosis?