Question
A 36-year-old man who was hit by a car presents to the ER complaining of abdominal pain. His vital signs are HR 92, BP 127/65, and RR 16. On examination, he has tenderness to palpation in the right upper quadrant. An ultrasound examination is performed and reveals fluid between the liver and the kidney in Morison’s pouch. Which of the following is the most appropriate next step in his management?
| A. |
CT scan of the abdomen/pelvis |
| B. |
Intravenous pyelogram |
| C. |
Angiography |
| D. |
Diagnostic laparoscopy |
Show Answer
|
Correct Answer � A Explanation |
 |
Answer- A CT scan of the abdomen/pelvis
He is hemodynamically stable, he should undergo a CT scan of the abdomen and pelvis to evaluate for solid organ or hollow viscus injury. His initial evaluation by ultrasound (focused assessment with sonography in trauma or FAST) showed fluid in Morison’s pouch or the space between the liver and the right kidney, which could indicate a liver injury. FAST has largely replaced DPL as the initial test of choice for evaluation for abdominal injury after blunt trauma.