TRAUMATIC GASTRIC TRANSECTION - A CASE-REPORT

This report documents the first known pediatric survivor of seat-belt- associated gastric transection, An Il year-old boy presented with abdo minal ecchymoses after a motor vehicle accident. Physical and radiolog ical examination determined the need for abdominal exploration. During the operation, a near-complete transection of the stomach was found, which was repaired by primary anastomosis. After an initially unremark able recovery period, gastric stasis and pyloric obstruction developed . Radiologically and endoscopically, this was determined to be seconda ry to a traumatic distal vagotomy. Neither gastric transection nor tra umatic vagotomy had been reported previously in the pediatric populati on with abdominal seat-belt injuries. This report demonstrates an exce ptionally rare seat-belt-related injury, and its unusual postoperative complication. It also emphasizes the significance of the ''seat-belt sign'' in the assessment of motor vehicle-related blunt abdominal trau ma, and outlines potential problems associated with the wearing of adu lt-designed lap belts by pediatric passengers. Copyright (C) 1996 by W .B. Saunders Company