Man With Severe Abdominal Pain

Abstract

A 51-year-old man presented to the emergency department with severe abdominal pain after losing control of a pressure washer and the nozzle striking his abdomen. Physical examination revealed a small wound over the right periumbilical region (Figure 1) and diffuse tenderness out of proportion to the apparent injury with voluntary guarding. An emergency upright chest radiograph prompted emergency computed tomography imaging of the abdomen, given concerning findings (Figure 2, Figure 3). The patient was transferred to a level 1 trauma center for definitive treatment.