UNASSIGNED: Seat belt syndrome (SBS) is a rare condition described as injuries sustained due to thoracic, abdominal, and pelvic compression in the context of traffic accidents. These injuries can range from minor skin abrasions to large lesions of internal organs and spinal cord involvement. Traumatic abdominal wall hernias (TAWH) are one of the injuries that can be associated.
METHODS: A 21-year-old male suffered a severe injury, resulting in complete transection of all abdominal wall musculature due to SBS, with associated visceral injury. Emergency surgery included intestinal and sigmoid colon resection, along with cava vein repair. After a prolonged recovery, a second-stage surgery for abdominal wall reconstruction was planned. Prehabilitation involved botulinum toxin and pneumoperitoneum, with surgical planning utilizing CT scan and 3D reconstruction. The second-stage surgery included transversus abdominis release and placement of double mesh.
UNASSIGNED: Managing traumatic abdominal wall hernias in polytrauma patients necessitates emergent surgery for vital injuries, while reconstructive surgery timing is crucial, with patient preparation being essential. Surgical planning, including 3D reconstructions, enhances accuracy, and safety, with repair technique selection depending on anatomical features. Given our patient\'s athletic background and preoperative vascular CT findings, flapless reconstructive surgery was chosen to mitigate vascular risks.
CONCLUSIONS: The therapeutic approach to traumatic abdominal wall injuries should be individualized to each patient, with a focus on addressing vital injuries first and considering abdominal wall reconstruction surgery at a subsequent stage. Utilizing CT scan with 3D reconstruction can be a valuable tool for preoperative planning in cases involving significant abdominal wall defects.

A rare case of an ascending colon injury and ileal perforation in a 34-year-old male patient due to blunt abdominal trauma caused by a road traffic accident is reported in this study. This paper reports the clinical and imaging findings of seat belt syndrome. The seat belt syndrome primarily involves soft tissue injury; however, lacerations of the colon, small intestine, and mesentery have rarely been reported in the literature. However intestinal injuries, including bowel perforation and mesenteric injuries due to seat belt syndrome, must not be underestimated because they usually require emergency laparotomy because of accompanying peritonitis and hemorrhaging, and can be lethal if left untreated. Therefore, when an ascending mesocolon hematoma and free gas in the peritoneal cavity are present, gastrointestinal perforation due to seat belt syndrome should be suspected. In this case, gastrointestinal perforation was suspected based on the computed tomography findings, and emergency surgery was performed; the patient\'s course was uneventful without any postoperative complications. Early diagnosis and management are essential to prevent associated morbidity and mortality.

UNASSIGNED: Seat belt syndrome is associated with multiple visceral injuries and vertebral burst fractures. Small Intestinal perforations are seen in 5-15 % of blunt abdominal trauma. In our case, we will report a case that presented small intestinal perforation and thoracic vertebral fracture caused by a different mechanism.
METHODS: Previously healthy 48-year-old male presented to the emergency department following falling from 15 feats height. He was a paraplegic with a sensory level at T12. He did not have a clinical feature of spinal shock. He was complaining of epigastric and central abdominal pain and tenderness and was diagnosed to have a proximal Jejunal perforation associated with an unstable fracture of T12 causing spinal compression. Open intestinal repair followed by a posterior spinal exploration and pedicle screw fixation done.
UNASSIGNED: Violent injury due to different mechanisms can have similar injuries to Seat belt syndrome. Ultrasonography is used to detect pneumoperitoneum, but the Contrast study is the gold standard to detect visceral injuries. The surgical approach to visceral injury depends on the patient\'s condition. But the laparoscopic approach has a more favorable postoperative outcome than open access.
CONCLUSIONS: Intestinal perforations associated with the neurological deficit are difficult to identify in an initial clinical assessment. Thoracolumbar fractures can associate with small bowel injuries during high-velocity trauma. Early identification and repair of the intestinal injury are important to prevent devastating complications and to improve neurological recovery after spinal surgery.

Seat belt syndrome (SBS) represents all injury profiles associated with seat belt injuries and motor vehicle crashes (MVCs). Seat belt syndrome classically presents with a superficial seat belt sign that may signify deeper intra-abdominal and/or spinal involvement. The amount of force transmitted from the restraint to the passenger ultimately dictates the amount and severity of the injury. We present a unique case of a 59-year-old female involved in a motor vehicle crash with multiple traumatic injuries, including seat belt syndrome, abdominal wall transection, and bowel injuries. She later had reconstruction of her traumatic abdominal wall hernias (TAWHs). Three unique approaches were used in the management of her traumatic abdominal wall hernias: (1) preoperative Botulinum toxin (Botox) injections, (2) operative use of biologic and bioabsorbable meshes in contaminated fields, and (3) postoperative physical therapy and body positioning. The patient did not experience any recurrence of these hernias after her abdominal wall reconstruction and remains alive at the time this case was written. The diagnostic criteria and surgical management of traumatic abdominal wall hernias have yet to be established, and the case presented here provides approaches that should serve as future areas for study.

We report herein our experience with a 10-year-old girl who incurred injuries consistent with seat belt syndrome. The patient was involved in a low-speed motor vehicle accident while restrained in a three-point belt (shoulder and lap belts). She complained of abdominal pain and developed tenderness and abdominal guarding. On admission, enhanced computed tomography (CT) demonstrated a fluid collection in the pelvis and a fractured vertebra in the lumbar spine. The following day, her C-reactive protein and serum amylase levels were elevated and plain CT demonstrated free air in the left side of the abdominal cavity. A ruptured jejunum was detected on laparoscopy. The involved segment of intestine was resected and an end-to-end anastomosis performed. She had an uneventful post-operative course. On post-operative day 14, she was transferred to another facility to undergo therapy for her spinal fracture. After completing conservative therapy, she was discharged 5 weeks after the initial injury.

BACKGROUND: Seat belt injuries are not uncommon. The use of seat belts is associated with a unique injury profile collectively termed \"the seat belt syndrome\". The aim is to aid in the early diagnosis of seat belt injuries.
METHODS: Two different patients presented to the emergency after sustaining a motor vehicle accident. Both were the drivers, restrained and had a frontal impact. On presentation they were hemodynamically stable with mild tenderness on the abdomen and the abdominal computed tomography (CT) did not show any signs of bowel or mesenteric injuries. The signs of peritonitis became obvious after 24h in one case and after 3 days in the other.
CONCLUSIONS: Early diagnosis provides better outcomes for patients with seat belt injuries, but this remains a challenge to trauma surgeons. The typical findings of peritonitis might not be present initially. The presence of abdominal wall ecchymosis (seat belt sign) increases the chance of intraabdominal injuries by eight folds.
CONCLUSIONS: Clinical signs of intestinal injuries might not be obvious on presentation. In the presence of seat belt sign the possibility of bowl injury must be suspected. Admit the patient for observation even if no clinical or radiological findings are present at presentation.