A patient involved in a high-speed motor vehicle collision presents with abdominal pain, distention, and hypotension. Upon ultrasound examination in the emergency department, free fluid is observed in the abdomen. Which of the following is the most likely diagnosis?
Solid organ injury
Hollow organ injury
Diaphragmatic injury
Retroperitoneal injury
The most likely diagnosis in this scenario is a solid organ injury. High-speed collisions often result in significant blunt abdominal trauma, leading to injuries of solid organs such as the liver and spleen, which can cause internal bleeding. The presence of free fluid, as observed on the ultrasound, is indicative of internal hemorrhage. Hollow organ injuries typically present differently and may not show free fluid unless there is a perforation and subsequent peritonitis. Diaphragmatic injuries and retroperitoneal injuries can also occur, but they are less likely to present with the described symptoms immediately and would typically be associated with other clinical signs.
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