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

Clinical presentation varies according to the organ injured. In hollow-viscus injuries, patients may develop signs of peritoneal irritation, such as abdominal tenderness, guarding, or rebound. In contrast, injuries to solid organs or major vessels more commonly produce features of hypovolemia, including tachycardia, hypotension, and signs of circulatory instability. [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]

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.
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