Seat belt syndrome

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Seatbelt syndrome is defined as a seatbelt sign associated with lumbar spine fracture and bowel perforation. Seatbelt syndrom.jpg
Seatbelt syndrome is defined as a seatbelt sign associated with lumbar spine fracture and bowel perforation.

Seat belt syndrome is a collective term that includes all injury profiles associated with the use of seat belts. It is defined classically as a seat belt sign (seat belt marks on the body) plus an intra-abdominal organ injury (e.g. bowel perforations) and/or thoraco-lumbar vertebral fractures. [1] The seat-belt sign was originally described by Garrett and Braunstein in 1962 as linear ecchymosis of the abdominal wall following a motor vehicle accident. [2] It is indicative of an internal injury in as many as 30% of cases seen in the emergency department. [3] [4] Disruption of the abdominal wall musculature can also occur but is relatively uncommon. [5]

Contents

Apart from the medical aspects of injury, there are some legal issues associated with seat belt injuries. If your seat belt fails and this can be proved, then you may be entitled to compensation. On the other hand, it may be argued that you did not wear your seat belt as it was intended or designed. [6]

Symptoms

The symptoms associated with this syndrome depend on the injured organ. In the case of hollow organs injuries, peritoneal signs may appear. While in the case of parenchymal or vascular injuries, hypovolemic signs dominate the clinical picture. [1]

Pathogenesis

Seat belt syndrome is caused by hyperflexion of the spine around the lap strap in sudden deceleration leading to crushing of intra-abdominal contents between the spine and the seatbelt. Fixed portions of the bowel such as proximal jejunum and distal ileum are more susceptible to injury than mobile portions since mobile segments can escape the high pressure and resultant damage. [7]

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<span class="mw-page-title-main">Peritonitis</span> Medical condition

Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome.

<span class="mw-page-title-main">Bowel obstruction</span> Medical condition

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<span class="mw-page-title-main">Abdominal pain</span> Stomach aches

Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a differential diagnosis is extremely important.

<span class="mw-page-title-main">Diverticulitis</span> Digestive disease of the large intestine

Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine. Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. There may also be nausea, diarrhea or constipation. Fever or blood in the stool suggests a complication. People may experience a single attack, repeated attacks, or ongoing "smouldering" diverticulitis.

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<span class="mw-page-title-main">Blunt trauma</span> Trauma to the body without penetration of the skin

Blunt trauma, also known as blunt force trauma or non-penetrating trauma, describes a physical trauma due to a forceful impact without penetration of the body's surface. Blunt trauma stands in contrast with penetrating trauma, which occurs when an object pierces the skin, enters body tissue, and creates an open wound. Blunt trauma occurs due to direct physical trauma or impactful force to a body part. Such incidents often occur with road traffic collisions, assaults, sports-related injuries, and are notably common among the elderly who experience falls.

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<span class="mw-page-title-main">Bowel resection</span> Surgical procedure in which a part of an intestine is removed

A bowel resection or enterectomy is a surgical procedure in which a part of an intestine (bowel) is removed, from either the small intestine or large intestine. Often the word enterectomy is reserved for the sense of small bowel resection, in distinction from colectomy, which covers the sense of large bowel resection. Bowel resection may be performed to treat gastrointestinal cancer, bowel ischemia, necrosis, or obstruction due to scar tissue, volvulus, and hernias. Some patients require ileostomy or colostomy after this procedure as alternative means of excretion. Complications of the procedure may include anastomotic leak or dehiscence, hernias, or adhesions causing partial or complete bowel obstruction. Depending on which part and how much of the intestines are removed, there may be digestive and metabolic challenges afterward, such as short bowel syndrome.

<span class="mw-page-title-main">Gunshot wound</span> Injury caused by a bullet

A gunshot wound (GSW) is a penetrating injury caused by a projectile from a gun. Damages may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of the body, and in severe cases, death. Damage depends on the part of the body hit, the path the bullet follows through the body, and the type and speed of the bullet. Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and debility, and lead poisoning.

<span class="mw-page-title-main">Chance fracture</span> Medical condition

A Chance fracture is a type of vertebral fracture that results from excessive flexion of the spine. Symptoms may include abdominal bruising, or less commonly paralysis of the legs. In around half of cases there is an associated abdominal injury such as a splenic rupture, small bowel injury, pancreatic injury, or mesenteric tear. Injury to the bowel may not be apparent on the first day.

<span class="mw-page-title-main">Sternal fracture</span> Medical condition

A sternal fracture is a fracture of the sternum, located in the center of the chest. The injury, which occurs in 5–8% of people who experience significant blunt chest trauma, may occur in vehicle accidents, when the still-moving chest strikes a steering wheel or dashboard or is injured by a seatbelt. Cardiopulmonary resuscitation (CPR), has also been known to cause thoracic injury, including sternum and rib fractures. Sternal fractures may also occur as a pathological fracture, in people who have weakened bone in their sternum, due to another disease process. Sternal fracture can interfere with breathing by making it more painful; however, its primary significance is that it can indicate the presence of serious associated internal injuries, especially to the heart and lungs.

<span class="mw-page-title-main">Abdominal trauma</span> Medical condition

Abdominal trauma is an injury to the abdomen. Signs and symptoms include abdominal pain, tenderness, rigidity, and bruising of the external abdomen. Complications may include blood loss and infection.

<span class="mw-page-title-main">Diaphragmatic rupture</span> Tear in the thoracic diaphragm, usually caused by physical trauma

Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in breathing. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 0.5% of all people with trauma.

Abdominal compartment syndrome (ACS) occurs when the abdomen becomes subject to increased pressure reaching past the point of intra-abdominal hypertension (IAH). ACS is present when intra-abdominal pressure rises and is sustained at > 20 mmHg and there is new organ dysfunction or failure. ACS is classified into three groups: Primary, secondary and recurrent ACS. It is not a disease and as such it occurs in conjunction with many disease processes, either due to the primary illness or in association with treatment interventions. Specific cause of abdominal compartment syndrome is not known, although some causes can be sepsis and severe abdominal trauma. Increasing pressure reduces blood flow to abdominal organs and impairs pulmonary, cardiovascular, renal, and gastro-intestinal (GI) function, causing obstructive shock, multiple organ dysfunction syndrome and death.

References

  1. 1 2 TORBA, M.; HIJAZI, S.; GJATA, A.; BUCI, S.; MADANI, R.; SUBASHI, K. (1 September 2014). "Seat belt syndrome, a new pattern of injury in developing countries. Case report and review of literature". G Chir. 35 (7–8): 177–180. PMC   4321524 . PMID   25174292.
  2. Wotherspoon, Sonya; Chu, Kevin; Brown, Anthony FT (1 March 2001). "Abdominal injury and the seat‐belt sign". Emergency Medicine Australasia. 13 (1): 61–65. doi:10.1046/j.1442-2026.2001.00180.x. PMID   11476415.
  3. Masudi, Tahir; McMahon, Helen Capitelli; Scott, Jennifer L.; Lockey, Andrew S. (1 January 2017). "Seat belt-related injuries: A surgical perspective". J Emerg Trauma Shock. 10 (2): 70–73. doi: 10.4103/0974-2700.201590 . PMC   5357874 . PMID   28367011.
  4. Girelli, G.; Di Natale, R.; Manocchi, M. C.; Lutman, M. (1 October 1993). "[Seat belt syndrome]". Radiol Med. 86 (4): 444–452. PMID   8248580.
  5. Wagner, AC (1979). "Disruption of abdominal wall musculature: unusual feature of seat belt syndrome". American Journal of Roentgenology. 133 (4): 753–754. doi:10.2214/ajr.133.4.753. PMID   158297.
  6. "What You Need to Know About Car Accident Seat Belt Injuries". ELMENS.com. Jan 2, 2021. Retrieved October 30, 2022.
  7. Abbas, Alaa K.; Hefny, Ashraf F.; Abu-Zidan, Fikri M. (1 January 2011). "Seatbelts and road traffic collision injuries". World Journal of Emergency Surgery. 6 (1): 18. doi: 10.1186/1749-7922-6-18 . PMC   3121590 . PMID   21619677.