A case of gastric mucosal laceration due to seat belt injury

Abstract

A 69-year-old man was involved in a road traffic accident wherein his car hit a telegraph pole and turned over. He reported wearing a seatbelt and denied any injuries or pain at that time. Six hours after the accident, however, he developed melena and hematemesis. Computed tomography performed on admission to our hospital revealed no evidence of traumatic pneumothorax, intra-abdominal bleeding, or pneumoperitoneum. However, there was evidence of contrast medium leakage from the stomach. Emergency endoscopy revealed a mucosal laceration on the lesser curvature in the cardiac region, with evidence of arterial hemorrhage from visible vessels. Hemostasis was achieved endoscopically by injection of hypertonic saline-epinephrine and clipping. Endoscopic treatment of gastric injury following blunt abdominal trauma is rare. Here we report a case and present a review of the relevant literature.