system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 28-year-old man is brought to the emergency department with shortness of breath and chest pain, 35 minutes after he was involved in a high-speed motor vehicle collision. He was the helmeted driver of a scooter hit by a truck. On arrival, he is alert and oriented with a Glasgow Coma Scale rating of 14. His temperature is 37.3°C (99.1°F), pulse is 103/min, respirations are 33/min and blood pressure is 132/88 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%. Examination shows multiple abrasions over his abdomen and extremities. There is a 2.5-cm (1-in) laceration on the left side of the chest. There are decreased breath sounds over the left base. Cardiac examination shows no abnormalities. The abdomen is soft and there is tenderness to palpation over the left upper quadrant. Bowel sounds are normal. His hemoglobin concentration is 13.6 g/dL, leukocyte count is 9,110/mm3, and platelet count is 190,000/mm3. A chest x-ray is shown. Which of the following is the most likely diagnosis?
assistant
Diaphragmatic rupture