title: Nonoperative management of pediatric aortic injury with seat belt syndrome.
abstract: "Seat belt syndrome" was first described by Garret and Braunstein in 1962. The syndrome involves skin and abdominal wall ecchymosis (seat belt sign) intra-abdominal solid organ and visceral injuries, as well as Chance fractures (compression and/or wedging deformity of the anterior portion of the vertebral body with disruption or fracture of the posterior elements, generally at L1-L3). We present a case of a 12-year-old male involved in a high-speed motor vehicle collision wearing only a lap belt resulting in seat belt syndrome, with disruption of the abdominal wall, mesenteric avulsion with multiple intestinal perforations, abdominal aortic dissection, and an L2 Chance fracture with cord transection. Intraoperative decision making is outlined with this scenario of complex injuries, and the literature of seat belt syndrome associated with blunt aortic injuries and its management is reviewed.
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, VA.
authors.forename: Dan W
authors.initials: DW
authors.lastname: Parrish
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Barnhorst
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, VA.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Trebska-McGowan
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, VA.
authors.forename: Michael
authors.initials: M
authors.lastname: Amendola
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, VA; Children's Hospital of Richmond, Virginia Commonwealth University Health System, Richmond, VA. Electronic address: jhaynes@mcvh-vcu.edu.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Haynes
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000063:Accidents, Traffic; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000293:injuries*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001027:Aortography / Q000379:methods; D002648:Child; D006801:Humans; D008297:Male; D012622:Seat Belts / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*