Background: Seat belt usage can lead to injuries like the
"Seat-belt sign," an abdominal bruising from compression forces. When
coupled with internal or lumbar injuries, this forms "Seat Belt Syndrome
Objective: This report details the case of a young male involved in a frontal collision,
presenting with severe multiple complicated injuries including abdominal trauma with
multiple damage control surgeries. Case presentation: The patient presented to the
emergency department after road traffic accident with a seat belt sign, Exploratory
laparotomy unveiled extensive injuries, including complete jejunal transaction, avulsion
of the terminal ileum, sigmoid mesentery avulsion, and rectosigmoid junction degloving
with left anterolateral muscle destruction forming a traumatic hernia. Surgical
interventions included jejunal resection and anastomosis, ileocecal limited resection
and anastomosis, lastly Hartmann procedure and left high colostomy creation. Subsequent
procedures addressed complications, in form of anastomotic leakage managed with
resection of the ileocolic anastomosis and ileostomy creation, Vacuum-Assisted Closure
dressing, and biological mesh placement to manage abdominal wall infection and
dehiscence. After one year the patient underwent surgery for ileostomy and colostomy
reversal, along with abdominal wall reconstruction using biosynthetic mesh. Conclusion:
Managing injuries involving the jejunum, ileum, and rectosigmoid requires careful
surgical intervention, considering individual cases and surgeon judgment. Our experience
highlights the need for a modification in the emergency room policies, advocating
immediate computed tomography scans for patients with seat belt signs for early
detection and improved outcomes.
[Med Arch 2024; 78(3.000): 244-246]

General Surgery, Trauma, Abdominal injury, motor vehicle accident