MCQ – 96486

Seat belt injuries can result from high-impact events like car accidents where the force exerted by the seat belt can cause various types of trauma. Which of the following is a potential injury directly associated with seat belt use during a vehicular accident?

Correct Answer » C Explanation

The seat-belt syndrome refers to a constellation of injuries resulting from the restraint forces exerted by a seat belt during sudden deceleration, such as in a motor vehicle accident.

The lap portion of the seat belt can compress abdominal viscera against the vertebral column, while rapid deceleration produces shearing forces. These mechanisms commonly result in:

• Mesenteric tears
• Small bowel perforation
• Bowel wall hematoma
• Mesenteric vascular injury
• Lumbar spine flexion-distraction injury (Chance fracture)

Among these injuries, mesenteric tear is classically associated with seat-belt trauma.

Why Option C is Correct: Mesenteric Tear

• Caused by shearing forces during rapid deceleration.
• The bowel continues to move while the mesentery is fixed, resulting in tearing.
• May lead to:
  • Mesenteric hematoma
  • Bowel ischemia
  • Internal bleeding
  • Delayed bowel perforation
• Often associated with the seat-belt sign (abrasion/ecchymosis across the abdomen).

Why the Other Options Are Incorrect

A. Splenic laceration

• Can occur in blunt abdominal trauma.
• Usually results from impact to the left upper abdomen or lower chest.
• Not considered a characteristic or classic seat-belt injury.

B. Splenic contusion

• Also occurs after blunt trauma.
• Less specific for seat-belt injury than mesenteric tears.

D. Mesenteric adenitis

• Inflammation of mesenteric lymph nodes.
• Usually due to viral or bacterial infection.
• Not a traumatic injury and has no relation to seat-belt trauma.