Anatomy clinical correlates Quiz: Ace Your Exams

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A 26-year-old man is brought to the emergency department by the local paramedics after a motor vehicle collision. He was wearing a seat belt while driving, and his car was hit by a truck from the left side. The patient reports severe abdominal pain radiating to the left shoulder, nausea, and dizziness. Temperature is 36.7°C (98°F), pulse is 110/min, respirations are 20/min and blood pressure is 85/50 mmHg. Physical examination shows an area of ecchymosis over the left lower chest wall, diffuse abdominal tenderness, and dullness to percussion over the left upper quadrant. Lungs are clear to auscultation bilaterally. Focused assessment with sonography for trauma (FAST) reveals intraperitoneal free fluid. CT scan with contrast of the abdomen and pelvis is performed, as shown below. Which of the following is the most likely cause of this patient’s presentation?  


Reproduced from: Radiopedia

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