Abdominal injury and the seat‐belt sign

Abstract

Objective: To report on: 1. Prevalence of seat‐belt sign in motor vehicle accident victims with abdominal injuries; 2. Prevalence of intestinal injuries in patients with seat‐belt sign; and 3. Spectrum of abdominal injuries in a population with high usage of three‐point restraints. Methods: A retrospective chart review was conducted in an adult tertiary‐referral hospital from January 1992 to August 1998. Patients were identified from International Classification of Disease‐9 codes for abdominal wall and intra‐abdominal injuries. Results: The seat‐belt sign was present in 60/99. The proportion of intestinal injuries in patients with and without seat‐belt sign were 9/60 and 0/39, respectively (P = 0.01). In the 25 patients with intra‐abdominal injuries, there were 10 hepatic, 8 splenic, 9 intestinal and 4 retroperitoneal injuries. Conclusion: The seat‐belt sign is indicative of an increased risk of intestinal injury, which is difficult to detect with no single test providing reliable diagnosis. Other intra‐abdominal and retroperitoneal injuries may also occur, which are more readily diagnosed on computed tomography scan or focused abdominal utlrasound when available, but are no more frequent in patients with the seat‐belt sign than those without.

Low probability of Significant Intra-Abdominal Injury in Stable Patients with Abdominal ‘‘Seat Belt Sign’’

“…Neck abrasions are associated with injuries to the carotid artery, larynx, and cervical spine, chest abrasions are associated with fractures of the sternum, ribs, and clavicles as well as injuries to the heart and thoracic aorta, and abdominal abrasions indicate the likelihood of mesenteric tears, bowel perforation and other intraabdominal injury, chance fractures, and injuries to the abdominal aorta [8][9][10][11][12]. Some of the proposed mechanisms for these injuries include sudden compression of the internal organ between the seat belt and the spine, a sudden increase of intra-abdominal pressure, and shearing forces at fixed points in the aorta or intestinal mesentery [13,14].…”

Association Between the Seat Belt Sign and Intra‐abdominal Injuries in Children With Blunt Torso Trauma in Motor Vehicle Collisions

“…3 Using the correct restraint system and proper positioning of lap belts in children (low across the thighs and not across the abdomen) is important to reduce injuries. Prospective studies [4][5][6] and a review of crash injury network data 7 in adults indicate an association between the presence of the "seat belt sign" and intraabdominal injury, particularly involving the intestines or associated mesentery. Pediatric studies of this topic primarily consist of case series or retrospective reviews.…”

Pr�klinisches Management des Polytraumas

“…Im Verletzungsmuster nicht angeschnallter Pkw-Insassen dominieren schwere SHT (75%), wohin gegen bei angeschnallten Pkw-Insassen häufiger Verletzungen des Abdomens (83%) und der Wirbelsäule beobachtet werden. Bei Lateralunfällen sind Verletzungen des Thorax (80%), der unteren Extremität, des Abdomens (60%) und des Beckens (50%) besonders häufig [7,24,53,60,79,80]. Bei Heckauffahrunfällen kommt es besonders häufig zur Traumatisierung der HWS.…”

“…Das "seat-belt sign" dient als diagnostisches Zeichen für eine evtl. vorliegende abdominelle Verletzung (Präva-lenz 61%) [80].…”