الفهرس 
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Abstract
Clearly, hemodynamic instability or the identification of significant abnormalities during physical examination or a diagnostic procedure necessitates the involvement of a trauma surgeon.
Specific physical examination findings that call for timely surgical evaluation are as follows:
• History of blunt abdominal trauma, shock, or abnormal vital signs (eg, tachycardia, hypotension)
• Evidence of shock without obvious external blood loss
• Evidence of peritonitis (eg, marked tenderness, involuntary guarding, percussion tenderness)
• Findings consistent with potential intra-abdominal injury (eg, lap belt signs, lower rib fractures, lumbar spine fractures)
• Altered levels of consciousness or sensation, whether due to drugs, alcohol, or head/spinal injury
• Patients who require other prolonged operative intervention (eg, orthopedic procedures)
Specific findings on diagnostic studies that call for timely surgical evaluation include evidence of free fluid or solid organ injury on sonograms or CT scans.