A 16-year-old girl has fallen from her horse and kicked by the horse during her descent. She is now complaining of generalized abdominal pain and left shoulder-tip pain. Examination: She is talking and her chest examination is normal. The oxygen saturations are 100 percent on 24 percent oxygen. Initially, her pulse rate is 110/min with a blood pressure of 84/60 mmHg. She is slightly drowsy and her Glasgow Coma Score (GCS) is 14.
On examination of the abdomen, there is an abrasion on the left side beneath the costal margin with tenderness in the left upper quadrant. There is no evidence of any other injuries and the urinalysis is clear. The patient is given 2 L of intravenous fluids and the blood pressure improves to 130/90 mmHg. As the patient has now become stable, a computerized tomography scan (CT) of the chest and abdomen is obtained. The CT image is attached. On returning to the…
