Case of the Week — February Case #2: Pediatric Abdominal Pain

2 y/o WF unrestrained rear seat passenger in side impact MVC at highway speed. No ejection, airbags did deploy. Questionable LOC. PMHx: Full term infant. No hospitalizations. Immunizations UTD PSHx: none Meds: none Allergies: NKDA PE: GEN: thin, WF, ill appearing with poor eye contact HEENT: NCAT, TM clear B, OP clear, no c-spine TTP or crepitus CHEST: CTA B, non labored CV: RRR, no M/R/G ABD: soft, flat, mild TTP in LUQ, no rebound or guarding, +BS EXT: no C/C/E, multiple small abrasions to B UExt FAST exam is performed and illustrates the following: What is the diagnosis?