Case 14

11 y/o M presents after falling off his bike and getting hit in the stomach with the handle bars. Pt now has pain in the area and vomiting. No significant PMHx.  On PE he was TTP LLQ with guarding and rebound.  Labs unremarkable.

Vitals:

T  98.0 O 

HR  86 

RR  18 

BP  128 / 75 S 

O2 sat  99 ra  

1. The FAST images are below.  What do you see in these images?

2. A repeat FAST was done due to the mechanism of injury.  Are there any changes to the images?  If so, what?