Seat-belt syndrome revisited

This report describes a complex syndrome of injuries occurring in a young f emale who was a back seat passenger wearing a lap-belt restraint in a high- speed road traffic accident. As a consequence of the forced flexion distrac tion injury of her lumbar spine, she sustained a fracture-subluxation of th e first lumbar vertebra in association with a jejunal perforation and exten sive small intestinal mesenteric laceration. She also had a large traumatic hernia of the anterior abdominal wall, which was overlooked at primary lap arotomy. This report highlights collectively the classical combination of i njuries associated with the lap-belt syndrome and demonstrates the importan ce of carefully inspecting the anterior abdominal wall for deficiencies, be cause traumatic herniation may be easily overlooked.