A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra-abdominal trauma?

Question: A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra-abdominal trauma?

This question is a part of the ENPC 6th Edition Test Answers.

Answer

Constant left shoulder pain.

In a scenario involving a 6-year-old child who was involved in a boating crash and is awaiting surgical intervention for a fractured ankle, the manifestation that would warrant significant concern for the possibility of underlying intra-abdominal injury is the presence of persistent pain in the left shoulder.

This specific symptom is clinically significant as it may indicate the presence of referred pain from the abdomen to the shoulder, commonly associated with diaphragmatic irritation or injury. Such a phenomenon, often referred to as Kehr’s sign, can be indicative of internal bleeding or other forms of abdominal trauma.

This type of referred pain is a critical sign that healthcare providers look for when assessing patients for potential internal injuries following trauma, as it can help in identifying injuries that are not immediately visible or apparent.