Abstract
Six cases of bowel and mesenteric injury associated with seat belts were encountered from April 2010 to March 2013 in the First Department of Surgery of Dokkyo Medical University. The injuries comprised two cases of duodenal perforation, two cases of small intestinal perforation, and two cases of mesenteric injury. The two cases of duodenal perforation were considered to have resulted from the horizontal portion of the duodenum becoming sandwiched between the seatbelt and the vertebral column as the patient leaned forward, creating a closed intestinal loop. The two cases of mesenteric injury were considered to have resulted from direct damage to the intestinal mesentery by the seat belt. The two cases of small intestinal perforation and rupture were considered to have resulted from a combination of the above-described mechanisms. Three patients had a history of laparotomy, which may have predisposed them to injury because of the presence of adhesions and hardened tissue in the abdomen. Patients with blunt abdominal trauma caused by seat belts must be carefully evaluated with conventional methods such as physical findings, focused assessment with sonography for trauma, and computed tomography. The patient's body mass index and history of laparotomy should also be considered.
