A young woman was hit by a car and brought to the emergency room. She complained of pain in her abdomen and left chest. Tests revealed a collapsed left lung (pneumothorax) which was treated with a chest tube. Further evaluation found tender abdomen. A peritoneal lavage was performed which involves inserting a tube into the abdominal cavity to check for internal injuries. The lavage fluid drained from the chest tube, which should not occur based on normal anatomy. This phenomenon needs to be explained to determine if an internal organ was ruptured.