Case report
Seatbelt syndrome associated with an isolated rectal injury: case report
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* Corresponding author: Fikri M Abu-Zidan fabuzidan@uaeu.ac.ae
1 Department of Surgery, Al-Ain Hospital, Al-Ain, PO Box 1006, UAE
2 Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, PO Box 17666, UAE
World Journal of Emergency Surgery 2010, 5:4 doi:10.1186/1749-7922-5-4
Published: 4 February 2010Abstract
Seatbelt syndrome is defined as a seatbelt sign associated with a lumbar spine fracture and a bowel perforation. An isolated rectal perforation due to seatbelt syndrome is extremely rare. There is only one case reported in the Danish literature and non in the English literature. A 48-year old front seat restrained passenger was involved in a head-on collision. He had lower abdominal pain and back pain. Seatbelt mark was seen across the lower abdomen. Initial trauma CT scan was normal except for a burst fracture of L5 vertebra which was operated on by internal fixation on the same day. The patient continued to have abdominal pain. A repeated abdominal CT scan on the third day has shown free intraperitoneal air. Laparotomy has revealed a perforation of the proximal part of the rectum below the recto sigmoid junction. Hartmann's procedure was performed. The abdomen was left open. Gradual closure of the abdominal fascia over a period of two weeks was performed. Postoperatively, the patient had temporary urinary retention due to quada equina injury which resolved 10 months after surgery. The presence of a seatbelt sign and a lumbar fracture should raise the possibility of a bowel injury.