Which of the following is a sign of splenic injury and diaphragmatic irritation?

Left shoulder pain, also known as Kehr sign, is a sign of splenic injury and diaphragmatic irritation. It is caused by the irritation of the phrenic nerve, which innervates both the diaphragm and the shoulder, by blood or other fluids in the left upper quadrant. Tachypnea, flank pain, and hiccoughs are not specific signs of splenic injury or diaphragmatic irritation.

References:

Splenic trauma | Radiology Reference Article | Radiopaedia.org

Recognition and management of diaphragmatic injury in adults

Reference Guide for CCRN (Adult), page 14.