A 28-year-old man is brought to the emergency department via ambulance after being the unrestrained driver in a high-speed motor vehicle collision. On arrival, he is confused and diaphoretic. His temperature is (), pulse is , respirations are , and blood pressure is . Oxygen saturation is 96% on a non-rebreather mask. The airway is patent, and breath sounds are equal bilaterally. Intravenous access is established, and volume resuscitation is initiated. A portable chest radiograph reveals no abnormalities, and a pelvic radiograph shows no fractures. A Focused Assessment with Sonography for Trauma (FAST) examination demonstrates a distinct anechoic strip between the right kidney and the liver, as well as an anechoic fluid collection in the rectovesical pouch. Based on the interpretation of these imaging findings and the patient's clinical status, which of the following is the most appropriate next step in management?
- Proceed to emergent exploratory laparotomyCevap
- BPerform a computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast
- CAdminister a rapid bolus of intravenous crystalloid and repeat the ultrasound examination
- DPerform a diagnostic peritoneal lavage (DPL)
- EAdmit to the surgical intensive care unit for massive transfusion and serial abdominal examinations