Your patient is a 17-year-old male driver of a vehicle that received a lateral impact at the driver's side door. There are no side-impact airbags, and there is about 8 inches of intrusion into the passenger compartment at the left door. Your patient is complaining of left shoulder pain and pain "in his left side." He has a contusion on the left shoulder and deformity of the left clavicle. He has erythema over the left lateral thorax from ribs 6 through 12 with crepitus on palpation. Which of the following injuries should you suspect?
1) Blunt trauma to the spleen
2) Blunt trauma to the liver
3) Penetrating trauma to the spleen
4) Penetrating trauma to the liver
5) Left pneumothorax
6) Fracture of the left clavicle

Question

Quizplus · Accepted Answer

The left thoracic erythema and crepitus on palpation suggest a left-sided rib fracture, which could result in a pneumothorax (collapsed lung) on that side. Blunt trauma to the spleen or liver is less likely given the location of the impact (lateral rather than anterior) and the absence of signs of internal bleeding (such as hypotension or abdominal distension). Fracture of the left clavicle is a likely injury based on the patient's symptoms. Penetrating trauma is not suggested by the mechanism of injury.

Your Patient Is a 17-Year-Old Male Driver of a Vehicle