Teaching image withheldThe image will be revealed when it becomes clinically available in the case.
Operative photograph obtained after emergent exploratory laparotomy and abdominal exposure, showing an open abdomen with hemoperitoneum and active left-upper-quadrant bleeding consistent with traumatic splenic injury. • TEACHING IMAGE
Blunt Abdominal Trauma With Operative Splenic Hemorrhage
SCENARIO
An adult patient is brought to the trauma bay after a high-speed motor-vehicle collision. On arrival, the patient is pale, confused, and hypotensive with abdominal tenderness and guarding. Initial resuscitation includes blood products, large-bore vascular access, and activation of the massive transfusion protocol. eFAST demonstrates free intraperitoneal fluid in the right upper quadrant and pelvis. The patient remains persistently hypotensive despite initial resuscitation, so the trauma team proceeds directly to emergent exploratory laparotomy without CT. The uploaded operative photograph becomes available after abdominal entry and exposure.