A 19-year-old soccer goalie was involved in the play near his goal. During the game, his own teammate elbowed him in the anterior left abdomen. The boy dropped to the ground with vomiting and writhing in pain. PMH- No substantial PMH. Social ethanol use. Physical examination- Patient was writhing on the ground vomiting, with pain. On examination, Heart and lungs found to be clear with stable Vital signs.
Abdominal pain was significant. No bony tenderness on spinal or rib palpation. BP 120/73, HR 59, T 97F, RR 18, O2 sat 100% on arrival to Hospital Lab findings- WBC 9.4 81%PMN, HB 15.4, HCT 42.7, plt 225. INR 1.1 Cr 1.4, BUN 16, Na 136, K 3.9 Cl 102, CO2 24, glc 114 LFTs wnl, lipase 22, Ca 10.2. CT scan report- abdomen with contrast displayed delayed contrast extravasation with the leaking of urine in an area of left ureteropelvic junction or proximal ureter. No obstruction, free air or…
