An obvious deep stab wound. Simply needs to go to OT not waste time in ED. All the imaging mentioned will not change management.

There is a large amount of free fluid. No obvious injury to the liver is seen in this short video. Given the history he most likely has ruptured his spleen.

There is a AAST (American Association for the Surgery of Trauma) classification of splenic injuries from I to V. Essentially I is a < 1cm lac or capsular haematoma up to a V being a shattered spleen. This is a IV. Below is a radiopaedia link that fleshes it out.

https://radiopaedia.org/articles/aast-spleen-injury-scale?lang=us

CT is the preferred imaging modality. Very occasionaly (eg avulsions of the vascular pedicle, Grade 5 injuries) a nephrectomy is performed but generally the treatment of blunt trauma injuries of the kidney is conservative.

Harry Houdini always boasted that he had powerful abdominal muscles and could take any punch if braced. A University student punched him 4 times and he died a number of days later from a rupture of the appendix. The punch is thought to have caused the rupture.

With the widespread use of FAST and higher sensitivities of CT I cannot see a role for DPL in Sydney today. If FAST is negative and CT doesnt show anything but you are concerned for a small bowel or mesenteric injury---go to OT and have a look.

(Feel free to contact me and debate its role)

Chance fractures can occur in seatbelt injuries. Although of course any intrabdominal organ could be injured you need to especially think about duodenal and pancreatic injuries.

So----not perfect but pretty good.

Very uncommon. Essentially I suppose if you rupture your aorta from blunt or penetrating injury you are stuffed. Only the dissections or contained haematomas could make it to hospital.

A truly horrible feeling after you land on your back or front. Sitting in a crouch position is meant to assist the diaphragm to relax.