Approach to blunt and penetrating abdominal injury Quiz: Ace Your Exams

A 37-year-old woman is transported by emergency medical services (EMS) to the emergency department after being involved in a high-speed motor vehicle collision. The patient was the restrained driver of a vehicle traveling approximately 60 miles per hour when she was struck on the passenger side by another vehicle traveling at a similar speed. She currently has abdominal pain. She has no significant past medical history and does not take any medication. Temperature is 37°C (98.6°F), pulse is 115/min, respirations are 24/min, blood pressure is 106/54 mmHg, and oxygen saturation is 92% on room air. On arrival, the patient can state her name and has normal breathing sounds. Bilaterally. Cardiac exam is within normal limits. The extremities feel cold and clammy. She has a Glasgow coma scale (GCS) of 15. Secondary survey reveals ecchymosis over the upper abdomen overlying the area where the seatbelt would lie. Extended focused assessment with sonography in trauma (eFAST) is most likely to reveal which of the following findings?