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There is a history of abdominal trauma, often to the right side.

The signs of hepatic rupture include:

  • signs of blood loss:
    • pallor
    • tachycardia
    • hypotension, postural drop

  • signs of peritoneal irritation:
    • shoulder tip pain
    • guarding and abdominal rigidity

  • signs of a paralytic ileus:
    • loss of bowel sounds
    • abdominal distension