Matejka J, Pizingerová K, Vacek V, Zeman J
Klinika ortopedie a traumatologie pohybového ústrojí FN a LF UK v Plzni.
Acta Chir Orthop Traumatol Cech. 2010 Feb;77(1):61-4.
The authors report on a pre-school child with a typical presentation of the trauma caused by a car safety belt and termed the seat-belt syndrome. The deceleration mechanism which throws the upper body forward in the presence of a rigid belt over the abdominal region results in large contusions of the abdominal wall and trauma to the spine, retroperitoneum, and intra-abdominal organs, or even the chest. In making the diagnosis a thorough examination of the spine is necessary as well as a repeated surgical examination of the abdomen, because seat-belt syndrome is often associated with small intestine rupture, a symptom which can remain unrecognised at the early stage. In the case of a four-year-old boy described here, two loops of the small intestine were resected for perforation; stabilization of the vertebral column was indicated on the 5th post-injury day because of decompensated diabetes and deteriorated health state following intra-abdominal surgery. In this boy, poor compensation of juvenile diabetes resulted in infectious complications requiring repeated drainage of an abscess of the abdominal wall injured by the seat belt.The abdominal wall healed within 2 months, diabetes was managed with insulin therapy and good spondylodesis was achieved at 9 months after the injury.
作者报告了一名学龄前儿童，其表现出典型的汽车安全带所致创伤，被称为安全带综合征。在腹部区域有刚性安全带的情况下，上半身向前抛甩的减速机制会导致腹壁大面积挫伤以及脊柱、腹膜后和腹腔内器官甚至胸部的创伤。在进行诊断时，有必要对脊柱进行全面检查，并对腹部进行反复的外科检查，因为安全带综合征常与小肠破裂相关，而小肠破裂这一症状在早期可能未被识别。在此描述的一名4岁男孩的病例中，因小肠穿孔切除了两段小肠；由于腹腔手术后糖尿病失代偿且健康状况恶化，在受伤后第5天对脊柱进行了固定。在这个男孩身上，青少年糖尿病代偿不佳导致感染并发症，需要反复引流因安全带受伤的腹壁脓肿。腹壁在2个月内愈合，通过胰岛素治疗控制了糖尿病，受伤9个月后实现了良好的脊柱融合。
