Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of literature*

Abstract

Background: Classically, seat belt syndrome appears with seat belt marks on the body, bowel perforations, and lumbar spine fractures. However the symptoms are not limited to those previously mentioned, and organ damage can vary greatly.

Case report: A 34-year-old female passenger, was admitted to our hospital after a motor vehicle crash. The physical examination revealed an ecchymosis across the chest, a transverse abdominal abrasion, and fractures of the left humerus, the left femur, and the right tibia. The laparotomy revealed multiple jejunal perforations, such as a seromuscular tear of the hepatic and splenic flexure of the colon and a defect of the abdominal wall. The primary suture of jejunum, resection with end to end anastomosis of jejunum, suture of a seromuscular tear of the colon, and primary repair of the abdominal wall defect procedures were performed. On the fifth day, the patient underwent osteosynthesis.

Conclusion: The abdominal pain in the polytraumatized patients with seat belt syndrome may be dominated by the pain caused by extra-abdominal injuries. The presence of a seat belt mark across the abdomen increases suspicion of abdominal injuries.

Fig. 1

a, b, c, d - a) Seat belt signs in the thorax and abdomen. b) Fracture of the left humerus. c) Fracture of the left femur. d) Fracture of the right tibia.

Fig. 2

a, b - Intraoperative findings. a) Multiple jejunal perforation; b) Seromuscular tear of the splenic flexure.

Fig. 3

a, b, c - Osteosynthesis. a) Left humerus; b) left femur; c) right tibia.