A 45-year-old woman is admitted to the hospital after her automobile left the highway in a rainstorm and hit a tree. She had been wearing a seat belt. On radiographic examination, it is observed that she has suffered fractures of the ninth and tenth rib on her left side and that she has intraabdominal bleeding. Physical examination reveals hypovolemic shock and progressive hypotension. Which of the following organs is most likely injured to result in these clinical signs?

The spleen is a large lymphatic organ that rests against the diaphragm and ribs 9, 10, and 11 in the left hypochondriac area. A laceration of the organ is often associated with severe blood loss and shock. Almost all of the liver is located in the right hypochondrium and epigastrium, although some protrudes into the left hypochondrium below the diaphragm. The left kidney lies retroperitoneally approximately at the level of the T11 to L3 vertebrae on the left side of the body. The ilium is the upper portion of the hip bone and contributes to the bony pelvis. Ileum is the distal portion of the small intestine and is pronounced the same as "ilium."