| Popis: |
Background: The proper use of security accessories in cars has resulted in the reduction of morbidity and mortality both in adults and children. Improper use of abdominal seat belt is associated in some cases with severe abdominal injuries. Objectives: Investigation of the treatment outcomes of children who suffered complicated abdominal seat belt injuries between 1998 and 2013. Methods: We present five cases of children aged 6-14 years, who suffered complicated abdominal injuries due to improper use of the seat belt. Abdominal injuries included injuries to the liver, spleen, small bowel (duodenum, jejunum, and ileum), colon and aorta, mesenterial bleeding, retroperitoneal bleeding, bowel obstruction and pelvic fractures. Results: Three children were operated on within a few hours of admission due to peritoneal irritation, hemodynamic instability after fluid resuscitation, bowel injuries including perforation and bowel ischemia. Two children who were hemodynamically stable, were operated on after few days. One of them had a diagnosis of aortic injury and the other, bowel obstruction. The first child was treated in two stages: i. repair of duodenal rupture, and ii. repair of the aortic injury by using interposition Gore-Tex graft. For the child with bowel obstruction, segmental resection and primary anastomosis were performed. The operation and postoperative periods for all children were uneventful, and all five children are healthy today. Conclusion: 1) The abdominal seat belt should always be used in conjunction with the chest seat belt. 2) An abdominal seat belt sign should always raise the possibility of complicated abdominal injuries. 3) Gastrointestinal tract injuries are common in this setting. 4) Aortic injury is rare; however, it can easily be missed initially. 5) Abdominal aortic trauma is associated with duodenal injuries in almost all cases. |
