Seat belt syndrome: Delayed or missed intestinal injuries, a case report and review of literature

With the use of seatbelts comes a unique injury profile that has been called “the seatbelt syndrome.” The classically described “seatbelt sign” has become a pattern of injury, describing potential underlying damage. As a clinician, clues to the underlying damage follow a thorough physical examination including the removal of all clothing to locate abrasions and bruises to the skin that potentially follow a seatbelt pattern. Delayed presentation of an intra-abdominal injury in the setting of a seatbelt sign has been well documented; however, the question is how long to observe these patients. We present the case of a 17-year-old woman involved in a motor vehicle collision who presented to the emergency department (ED) hemodynamically stable with a lower abdominal wall seatbelt sign. Her initial imaging revealed only an abdominal wall contusion. She was admitted for observation. Approximately 12 h later she started developing abdominal pain, and by 14 h abdominal distention, with repeat imaging showing free fluid and free air. She was taken to the operating room for an exploratory laparotomy and was ultimately discharged back home on day 7.

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“…Subsequent exploratory laparotomy showed a mesenteric injury and devascularization of the terminal ileum. 6…”

Section: Discussionmentioning

confidence: 99%

Perforated Small Intestine: A Case of a Delayed Presentation of an Intra-Abdominal Injury in a Pediatric Patient With a Seatbelt Sign

Taylor

Zygowiec

Wallace

et al. 2019

Clin Med Insights Pediatr

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“…A former aviation engineer, Nils Bohlin, is credited for developing this innovative seatbelt design for Volvo, and customers in the Scandinavian market had access to vehicles with three-point seatbelts as early as 1959 [3]. Although they have also been associated with seatbelt-related injuries [4,5], 1991-1997 data from the US Fatality Analysis Reporting System on head-on collisions show a 72% decreased odds of death when passengers are using a three-point seatbelt compared with no seatbelt [6]. This means more lives saved over the previous model of two-point lap-only seatbelts which were associated with a 57% decreased odds of death [6].…”

Section: Seatbelts Save Livesmentioning

confidence: 99%

Fasten your seatbelts: innovation in regional anaesthesia is a bumpy ride

Mariano

El‐Boghdadly

2020

Anaesthesia

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“…In a review of the literature on intra-abdominal trauma secondary to seat-belt injuries, almost every patient had intestinal segment injury. Early diagnosis leads to better outcomes for patients with seat belt injuries, but the diagnosis can be challenging as the typical finding of peritonitis might not be present initially [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

A case of seat belt-induced small bowel rupture and Chance fracture accompanied by elevated serum amylase

Tatekawa

2021

Journal of Surgical Case Reports

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We report herein our experience with a 10-year-old girl who incurred injuries consistent with seat belt syndrome. The patient was involved in a low-speed motor vehicle accident while restrained in a three-point belt (shoulder and lap belts). She complained of abdominal pain and developed tenderness and abdominal guarding. On admission, enhanced computed tomography (CT) demonstrated a fluid collection in the pelvis and a fractured vertebra in the lumbar spine. The following day, her C-reactive protein and serum amylase levels were elevated and plain CT demonstrated free air in the left side of the abdominal cavity. A ruptured jejunum was detected on laparoscopy. The involved segment of intestine was resected and an end-to-end anastomosis performed. She had an uneventful post-operative course. On post-operative day 14, she was transferred to another facility to undergo therapy for her spinal fracture. After completing conservative therapy, she was discharged 5 weeks after the initial injury.

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Seat belt syndrome: Delayed or missed intestinal injuries, a case report and review of literature

Abstract: HighlightsThe use of seat belts is associated with a unique injury profile collectively termed “the seat belt syndrome”.The typical findings of peritonitis might not be present initially.The chances of intra abdominal injury in the presence of seat belt sign increase eight folds.

Cited by 25 publications

References 9 publications

Perforated Small Intestine: A Case of a Delayed Presentation of an Intra-Abdominal Injury in a Pediatric Patient With a Seatbelt Sign

Perforated Small Intestine: A Case of a Delayed Presentation of an Intra-Abdominal Injury in a Pediatric Patient With a Seatbelt Sign

Fasten your seatbelts: innovation in regional anaesthesia is a bumpy ride

A case of seat belt-induced small bowel rupture and Chance fracture accompanied by elevated serum amylase

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