Parrish Dan W, Barnhorst Amanda, Trebska-McGowan Katarzyna, Amendola Michael, Haynes Jeffrey H
Department of Surgery, Virginia Commonwealth University, Richmond, VA.
Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA.
Ann Vasc Surg. 2015 Aug;29(6):1316.e1-6. doi: 10.1016/j.avsg.2015.02.019. Epub 2015 May 28.
"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.
“安全带综合征”于1962年由加勒特和布劳恩斯坦首次描述。该综合征包括皮肤和腹壁瘀斑（安全带征）、腹内实性器官和内脏损伤，以及Chance骨折（椎体前部压缩和/或楔形畸形，伴有后部结构破坏或骨折，通常发生在L1-L3）。我们报告一例12岁男性，他仅系着腰部安全带卷入高速机动车碰撞事故，导致安全带综合征，伴有腹壁破裂、肠系膜撕脱伴多处肠穿孔、腹主动脉夹层以及L2 Chance骨折伴脊髓横断。本文概述了针对这种复杂损伤情况的术中决策，并对与钝性主动脉损伤相关的安全带综合征及其处理的文献进行了综述。
