SEAT-BELT INJURY TO THE COMMON ILIAC ARTERY - CASE-REPORT

In traffic accident victims, the seat belt syndrome is a well known in jury which rarely involves the common iliac artery due to its posterio r anatomical position and to protection by the pelvis. We report a cas e of blunt abdominal trauma related to the type of seat belt worn. The trauma provoked subintimal haemorrhaging of the left common iliac art ery, without skeletal lesions or other visceral injuries. Correct diag nosis was delayed for three months after the crash, when an angiogram was performed to investigate disabling claudication and vascular pulse change in the left leg. This arterial injury could have been related to the association of two different types of force created during the crash (''compression/deceleration-type mechanism'') that might have pr oduced shearing forces causing a vascular wall discontinuity and/or an intimal flap. The authors speculate that the vascular lesion was obse rved on the same (left) side as the fastening point of the seat belt ( a lap-and-shoulder belt with a three-point attachment) where the shear ing forces may have been most intense due to the junction between the lap strap and the diagonal shoulder belt.