title: Seat belt syndrome: Delayed or missed intestinal injuries, a case report and review of literature.
abstract: 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.
authors.affiliation: Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates. Electronic address: lsalozaibi@gmail.com.
authors.forename: Labib
authors.initials: L
authors.lastname: Al-Ozaibi
authors.affiliation: Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Judy
authors.initials: J
authors.lastname: Adnan
authors.affiliation: Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Batool
authors.initials: B
authors.lastname: Hassan
authors.affiliation: Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Alya
authors.initials: A
authors.lastname: Al-Mazroui
authors.affiliation: Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Faisal
authors.initials: F
authors.lastname: Al-Badri
keywords: Blunt hollow viscus injury; Mesenteric injury; Seat belt injuries; Seat belt syndrome
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