In this case, the significant findings were a large anechoic space, absent fluid in the gut, and bilateral hydronephrosis. The differential diagnoses for these findings include cyst, bladder, and hematoma. Given the patient’s sudden decline and known coagulopathic state, a large, intraabdominal, spontaneous bleed such as an intraperitoneal bleed, rectus sheath hematoma, or retroperitoneal hematoma was a genuine concern. In both forms of intraabdominal bleeding, there is, nearly universally, a coagulopathy present and history of some form of minimal trauma (even coughing, in one case report).4 Patients usually report severe abdominal pain and a palpable mass is notable; however, some patients may present with abdominal compartment syndrome and multiorgan failure.5 The management is usually supportive with correction of coagulopathy; with abdominal compartment syndrome, surgical decompression and interventional embolization may be required.4-6 Point-of-care ultrasound is useful for making the diagnosis and appears as shown in Video 8. Differentiating blood from simple fluids like urine or uncomplicated ascites is straightforward unless the blood is acute without any coagulation present. On ultrasound, blood will usually appear as a complex anechoic space (nonhomogeneous), movement of echogenic collections may be visible, and there may be a gravity-dependent hyperechoic margin within the fluid space, representing a hematocrit sign. This can be seen on the CT scan of the same area shown in Video 8 and in Figure 5.