One of the big challenges facing the emergency room medical team is how to establish non-invasively the presence and extent of internal injury in a patient presenting with blunt abdominal trauma. Evaluating patients who have sustained blunt abdominal trauma (BAT) remains one of the most challenging and resource-intensive aspects of acute trauma care. Missed intra-abdominal injuries continue to cause preventable deaths. Physical examination findings are notoriously unreliable for several reasons; a few examples are the presence of distracting injuries, an altered mental state and drug and alcohol intoxication in the patient.