Abdominal trauma and referral thresholds

The abdomen hides litres of blood with little to show on the surface. After blunt trauma — road crashes, falls, cattle kicks, handlebar injuries — the spleen and liver bleed while the belly looks deceptively normal. At a facility without ultrasound, CT or a surgeon, your job is not to diagnose the exact organ: it is to detect danger and refer before the patient decompensates.