Abstract
A case of lumbar spine fracture and visceral injury associated with a lap-type seat belt is discussed. A 23-year-old man was a passenger in the rear seat of a vehicle and was wearing a lap-type seat belt. He was injured when the car hit a telegraph pole. The pre-impact speed was estimated to have been 40 kilometers per hour. In the emergency room, he complained of back pain without any neurological deficits, and X-ray films showed slight compression fracture of the first and second lumbar vertebrae. Abdominal CT scans showed no abnormalities. Ten hours after injury, the patient started to complain of abdominal pain and fullness. Repeat CT scans revealed abnormalities around the right kidney which suggested hematoma and free air. Laparotomy was performed fifteen hours after injury, revealing perforation of the duodenum and a jejunal hematoma. This case was interesting in that the patient had injuries to the abdominal viscera although the trauma and bony injuries were minor. We should pay more attention to the possibility of viscerai injury after car accidents, because many authors have suggested that a high rate of abdominal visceral injury is associated with lap-type seat belts.
