BLUNT GASTROINTESTINAL AND MESENTERIC INJURIES IN SEAT BELT WEARERS

Abstract

Six cases of gastrointestinal and mesenteric injuries in seat belt wearers, which were encountered from May, 1984 to December, 1987 in the Department of Gastroenterological Surgery of Saga Medical School, are reported. The six cases consisted of one case of jejunal perforation, two of perforations of both the small intestine and colon, one of seromuscular tears of both the small intestine and colon, and two of seromuscular tears of the colon. Three of five colonic injuries were seromuscular tears of the colon accompanied with mesenteric tears or hematomas. Five were males and one was femals, and their ages ranged 32 to 69 years with the average of 51.7 years. There was one death that was attributable to the anastomotic leakage followed by septic shock relating to over surgery for her attendant compromised condition. All patients except the female showed favorable and satisfactory postoperative courses. Even a careful preoperative evaluation can not afford an accurate diagnosis to blunt gastointestinal injuries. Computed tomography is the most useful diagnostic imaging for concomittent identification of both intraabdominal free air and fluid collection in such patients. Since the legislation of compulsory seat belt wearing in Japan, it seems that blunt abdominal injury due to seat belt may increase with an increase in number of traffic accidents. It is emphasized that we must carefully evaluate the patients of automobile accidents, bearing the fact in mindthat seat belt wearers have an unusually higher incidence of blunt gastrointestianl and mesenteric injuries.