The Strategy for the Treatment of Intra-Abdominal Organ Injury by Seat Belt

Abstract

Life-threatening trauma has decreased due to the improvement in the rate of wearing seat belts. On the other hand, blunt abdominal trauma due to seat belt has increased. The style of the trauma has attracted enough attention to be called ‘seat belt injury’. Due to the submarine phenomenon, a seat belt shifts to the abdomen, and organs in the abdominal cavity can be sandwiched between the abdominal wall and the vertebral body, and the seat belt injury occurs. We present here in two patients with seat belt injury that we experienced in our hospital. We demonstrate the mechanism of seat belt injury, the difference in damage caused by the kind of the seat belt, and the traffic rules about the seat belt in Japan. When we treat any traffic injury patient, we should always have coexistence of the intestinal tract damage in mind. Furthermore, we should keep it in mind that an intestinal tract explosion or an intestinal tract stenosis can occur at late onset after injury. In addition, we should usually deepen our understanding about the operative techniques specific to a variety organs because seat belt injury may cause the multiple organ damage other than the intestinal tract damage. In particular, injuries to the duodenum, pancreas, and diaphragm can be easily overlooked and we often pay the price later for having overlooked such injuries and their treatment.