Your 32 year old patient was kicked in the abdomen. He is pale but does not complain of abdominal pain. When you place him in a supine position with elevated legs, he complains of a sharp pain in his left shoulder. You should suspect

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The patient's symptoms suggest a ruptured spleen, particularly given the presence of referred pain to the left shoulder (Kehr's sign), which is indicative of diaphragmatic irritation by blood from the spleen.

Your 32 Year Old Patient Was Kicked in the Abdomen