In contrast, the closed chest trauma involving ruptures of thoracic organs and vessels causes 20–40% of motor vehicle fatalities and the thoracic aorta is ruptured in 10–20% of the fatalities (Greendyke 1966 Frey 1970 Sutorius et al. ( 1996) reported only 7 patients with abdominal aortic injury after blunt force in 5676 patients admitted with trauma. Blunt abdominal aortic injury is a rare entity. This type of safety belt is crossed over the chest and abdomen and holds the entire trunk better at dynamic loads in all directions.īlunt abdominal trauma with major vascular involvement is found to be rare (Freni et al. The safest seatbelt type for occupants with a similar anthropometric data would be the 4-point seat belt system, which is used in children’s car seats. It is incorrect to think that if the victim had not worn a seat belt, he would have survived. The driver’s body disproportion, combined with the restraining effect of the seat belt, could increase the risk of a fatal outcome. The improper position of the seat belt relative to the body affected the severity of abdominal injuries, instead of protecting from them. The specific anthropometric features of the victim had an impact on the mechanism of death. On the other hand, the forceful contact between the abdominal wall and the instrumental panel of the car generates pressure which transmits force through the adjacent organs to the aortic wall. The complications of the abdominal trauma result from the atypical position of the seat belt holding the upper and lower part of the body to the seat at two very distant levels, while between them the bulky, heavy midriff continued to move forward, carrying with it the vertebral column and surrounding anatomical structures. The autopsy revealed a transverse fracture of the body of tenth thoracic vertebra, complicated by a torn abdominal aorta, and severe bleeding into the abdominal cavity, which was the cause of the death. The lower part of the belt was in the inguinal region and the upper part was high on the chest, separated by the bulky midriff. The driver was found dead in the driver’s seat with the seat belt on. During the primary inspection of the crash site, it was found that the car had collided with a roadside pillar. It took place as a result of the car bonnet collision with a roadside pillar. Routine laparotomy or mandatory evaluation by specific diagnostic tests is not justified rather, a high index of suspicion with a low threshold for appropriate diagnostic evaluation and/or surgical exploration should be maintained for the optimal management of such patients.The aim of this report is to present a case of a blunt abdominal trauma with vascular and spinal involvements of an overweight man, caused by the front seat safety belt. The presence of the SBM sign should alert the physician to the high likelihood of specific internal injuries. There was a near 4-fold increase in thoracic trauma (22.5% versus 6% P=0.01) and a near 8-fold increase in intra-abdominal trauma (23% versus 3% P < 0.0001) between the groups of patients with and without SBMs. Three patients were found to have myocardial contusion, and 10 patients had intra-abdominal injuries (predominantly bowel and mesenteric lacerations) requiring laparotomy. No significant neck injuries were detected. Of patients with SBMs, 9 per cent had neck bruises, 32 per cent had chest bruises, 40 per cent had abdominal bruises, and 19 per cent had bruises in multiple sites. The injuries of these 77 patients were compared with the injuries of belted patients without an SBM sign. Of 650 car occupants, 410 (63%) were restrained and 77 (12%) had a SBM across the abdomen, chest or neck. The prospective study included consecutive patients involved in road traffic accidents who were admitted at an academic Level I trauma center. The objective of this study was to find the incidence of surgically correctable injuries in belted car occupants with a SBM sign and to define strategies of early detection and treatment of such injuries. No study has yet defined the exact incidence of injuries requiring intervention at the presence of this sign. Skin bruise corresponding to the site of the seat belt is known as the "seat belt mark" (SBM) sign and is associated with a high incidence of significant organ injuries. The use of seat belts is shown to cause a specific pattern of internal injuries.
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