It may sometimes result in a complete cut of these muscles, which happened in our second patient. In both of the previously presented cases, patients were using the 3 points restriction.īruising of the anterior abdominal wall is suggested to be due to the belt acting as a fulcrum on the soft muscles of the abdominal wall. In literature, the seat belt syndrome is associated mostly with the 2 points restriction “the lap belt”. Seat belts have gone through evolution, with the 3 points “lap and shoulder” retractable seat belt being the latest, most efficient and most commonly manufactured. The wound underwent proper primary healing and suture s removed on time. The drain was removed on a timely manner as planned. The post-operative course in regard to enteral feeding and mobilization was unremarkable. Resection and anastomosis of the involved segment done. She was posted of exploratory laparotomy which revealed perforation in the ileum ( Fig. On day 3 she started complaining of abdominal pain not responding to analgesia associated with vomiting, she was tachycardic, febrile and abdomen was tender with guarding. Patient admitted, open reduction and internal fixation of radius and ulna shaft done. Computed tomography (CT) abdomen showed no significant abdominal or pelvic findings. Abdominal examination showed seat belt sign and mild localized tenderness at the site of the abrasions. On presentation, she was conscious, breathing spontaneously, vitally stable and there were multiple abrasions on the nose and right hand with deformity in her left forearm. Ī 24 years old female, with no previous medical or surgical history, presented to emergency after sustaining road traffic accident, she was the driver, wearing seat belt and had front impact and airbag deployed. This article has been reported in line with the CARE criteria. We present two cases of intra-abdominal injuries due to seat belt with no clear signs of intra-abdominal injuries on presentation.
We believe that this article will help in the early diagnosis of seat belt injuries. Skin abrasions of the neck, chest and abdomen – i.e., the classic seat belt sign – indicate a high chance of an internal injury.Īlthough it is now generally accepted that injuries due to the seat belt can happen, few articles have been published on this subject and focused on the delayed presentation. The use of seat belts is associated with a unique injury profile collectively termed “the seat belt syndrome”. While a seat belt of good design and properly worn will prevent the occupants of a car being flung violently against the steering wheel, dashboard, or wind- screen, the force applied to the body by the restraining effect of the belt is considerable and increase the chance of intra-abdominal injuries. The use of seat belts has increased significantly in the last two decades, leading to a decrease in mortality from road traffic accidents (RTA).