Abstract
A 23-year-old man presented to the Emergency Department (ED) by ambulance with right flank pain after an all-terrain vehicle (ATV) accident. The patient's ATV collided with a tree and he was ejected from the vehicle. The patient had initially lost consciousness at the scene, but was alert and oriented upon arrival to the ED. The patient complained of severe pain to the right flank and abdomen. On examination, the patient's vital signs were: blood pressure 130/80 mm Hg, heart rate 140 beats/min, respirations 18 breaths/min, and room air oxygen saturation of 100%. The patient's abdomen was tender in the right upper quadrant and at the right costovertebral angle, without rebound tenderness, guarding, flank ecchymosis, or abrasions.
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