title: Seatbelt syndrome associated with an isolated rectal injury: case report.
abstract: 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.
authors.affiliation: Department of Surgery, Al-Ain Hospital, Al-Ain, PO Box 1006, UAE. fabuzidan@uaeu.ac.ae.
authors.forename: Ashraf F
authors.initials: AF
authors.lastname: Hefny
authors.forename: Yousef I
authors.initials: YI
authors.lastname: Al-Ashaal
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Bani-Hashem
authors.forename: Fikri M
authors.initials: FM
authors.lastname: Abu-Zidan