Review Question - QID 210783

A 24-year-old man is brought by ambulance to the emergency department after a motor vehicle accident. He was the front-seat driver in a head-on collision. He is currently unconscious. The patient’s past medical history is only notable for an allergy to amoxicillin as he developed a rash when it was given for a recent upper respiratory infection 1 week ago. Otherwise, he is a college student in good health. His temperature is 99.2°F (37.3°C), blood pressure is 97/58 mmHg, pulse is 112/min, respirations are 16/min, and oxygen saturation is 93% on room air. The patient is resuscitated. A FAST exam is notable for free fluid in Morrison pouch. An initial assessment demonstrates only minor bruises and scrapes on his body. After further resuscitation, the patient becomes responsive and begins vomiting. Which of the following is the most likely diagnosis?