Suspect significant intra-abdominal injury in any MWD that presents with abdominal rigidity or sensitivity to palpation, increasing abdominal size over time, visible bruising of the abdominal wall, or failure to respond to or deterioration in face of aggressive trauma resuscitation. Wounds involving more than the skin and superficial subcutaneous tissues dictate detailed examination to determine if the body wall was penetrated, and may require surgical exploration.