The pathway to diagnosis after blunt abdominal trauma. Unstable vitals are considered to be a systolic blood pressure less than 90 mmHg and/or new or delayed onset tachycardia of greater than 100 beats per minute. Unevaluable patients are those with a CCS score of less than 15 and/or clinical intoxication or combativeness. Abnormal abdominal examination findings included peritonitis, significant tenderness, or a seat belt sign. Other examination abnormalities indicative of an IAI included significant lower chest wall, flank, or lumbar spine tenderness. Distracting injuries include multiple lower rib fractures, pelvic fractures, or long bone fractures. A severe mechanism includes motor vehicle collisions at faster than 55 mph or a death at the scene. ABD, abdominal; Abnl, abnormal; OR, operating room; IR, interventional radiology.