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Case Reports: Unusual association of diseases/symptoms
Seat belt syndrome with caecal perforation and Chance fracture in an adolescent
  1. Christelle Destinval1,2,
  2. Olivier Larmure1,2,
  3. Pierre Journeau3 and
  4. Jean-Louis Lemelle1,2
  1. 1Pediatric Surgery, Nancy Regional University Hospital Center, Nancy, France
  2. 2Regional Hospital Centre Metz-Thionville, Metz, France
  3. 3Orthopaediatrics, Nancy Regional University Hospital Center, Nancy, France
  1. Correspondence to Dr Christelle Destinval; christelledestinval{at}yahoo.fr

Abstract

Seat belt syndrome describes a combination of injuries a person restrained by a seat belt may have after a high-velocity motor vehicle crash. A seat belt-shaped bruise may be present across the torso. A Chance fracture is a horizontal vertebral fracture, resulting from spinal hyperflexion, and in disruption of the three columns of the vertebral bodies. Its association with intra-abdominal injury is rare in children. A male, in early adolescence, was involved in a high-energy car crash. A total-body CT scan highlighted lacerations of the anterolateral abdominal wall and an acute L4 Chance fracture. Another CT scan performed because of clinical deterioration, showed cecal perforation, caused by a mesenteric tear and non-displaced fracture of the left sacral ala. He underwent a right hemicolectomy with ileocolic anastomosis and protective ileostomy and was immobilised in a body jacket orthosis for 3 months. The ileostomy was closed 3 months later. At 2-year follow-up, he is well.

  • Paediatric Surgery
  • Gastrointestinal surgery
  • Orthopaedics
  • Trauma

https://doi.org/10.1136/bcr-2023-254631

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: CD, OL, PJ and J-LL. The following authors gave final approval of the manuscript: CD, OL, PJ and J-LL.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.