This study is an analysis of 23 cases of seat belt injuries which were managed at the department of surgery, Masan Koryo General Hospital, from January 1986 to June 1991.
The peak age incidence was fourth decade and males predominate over females bya ratio of 4.75 : 1. The symptoms on admission were abdominal pain(96%), respiratory discomfort(17%) and chest pain. The common signs were abdominal tenderness(100%),
rigidity(61%), seat belt mark961%), rebound tenderness(30%) and distention(26%).
The diagnosis was made by mainly symptoms, signs, abdominal CT and paracentesis. Among 23 cases, 15 cases had emergency exploratory laparotomy, but the delayed diagnosis and laparotomy over 24 hours was made in 4 cases. The most cases were
combined
multiple injuries in extra-abdominal system and organs as well as intra-abdominal organs. The associated injuries include head, orthopedic and chest injury.
The intestinal and mesenteric injuries include contusion, seromuscular tearing, bowel ischemia, perforation, mesenteric tearing and/or hematoma and transection.
The postopeative complications were wound infection, intestinal obstruction, paralytic ileus, short bowel syndrome, pneumothorax and multiple organ failure.
Even though the use of seat belts has significantly decreased the mortality and morbidity of vehicle victims, surgeon should understand the peculiar pattern of seat belt injury accordingly in order to prompt diagnosis and management of the
patients.
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