Seat belt syndrome is a collective term that includes all injury profiles associated with the use of

seat belt A seat belt (also known as a safety belt, or spelled seatbelt) is a vehicle safety device designed to secure the driver or a passenger of a vehicle against harmful movement that may result during a collision or a sudden stop. A seat belt reduc ...

s. It is defined classically as a ''seat belt sign'' (seat belt marks on the body) plus an intra-abdominal organ injury (e.g. bowel perforations) and/or thoraco-

lumbar In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.'' The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...

vertebral fractures. The seat-belt sign was originally described by Garrett and Braunstein in 1962 as linear

ecchymosis A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close e ...

of the

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the v ...

following a motor vehicle accident. It is indicative of an internal injury in as many as 30% of cases seen in the emergency department. Disruption of the abdominal wall musculature can also occur but is relatively uncommon. Apart from the medical aspects of injury, there are some legal issues associated with seat belt injuries. If your seat belt fails and this can be proved, then you may be entitled to compensation. On the other hand, it may be argued that you did not wear your seat belt as it was intended or designed.

Symptoms

The symptoms associated with this syndrome depend on the injured organ. In the case of hollow organs injuries,

peritoneal The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothe ...

signs may appear. While in the case of parenchymal or vascular injuries, hypovolemic signs dominate the clinical picture.

Pathogenesis

Seat belt syndrome is caused by hyperflexion of the spine around the lap strap in sudden

deceleration In mechanics, acceleration is the rate of change of the velocity of an object with respect to time. Accelerations are vector quantities (in that they have magnitude and direction). The orientation of an object's acceleration is given by the ...

leading to crushing of intra-abdominal contents between the spine and the seatbelt. Fixed portions of the bowel such as proximal

jejunum The jejunum is the second part of the small intestine in humans and most higher vertebrates, including mammals, reptiles, and birds. Its lining is specialised for the absorption by enterocytes of small nutrient molecules which have been previous ...

and distal

ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine ma ...

are more susceptible to injury than mobile portions since mobile segments can escape the high pressure and resultant damage.

References

{{reflist Seat belts Traffic collisions