Pediatric Surgery, Nancy Regional University Hospital Center, Nancy, France
Regional Hospital Centre Metz-Thionville, Metz, France.
BMJ Case Rep. 2023 Oct 29;16(10):e254631. doi: 10.1136/bcr-2023-254631.
Seat belt syndrome describes a combination of injuries a person restrained by a seat belt may have after a high-velocity motor vehicle crash. A seat belt-shaped bruise may be present across the torso. A Chance fracture is a horizontal vertebral fracture, resulting from spinal hyperflexion, and in disruption of the three columns of the vertebral bodies. Its association with intra-abdominal injury is rare in children. A male, in early adolescence, was involved in a high-energy car crash. A total-body CT scan highlighted lacerations of the anterolateral abdominal wall and an acute L4 Chance fracture. Another CT scan performed because of clinical deterioration, showed cecal perforation, caused by a mesenteric tear and non-displaced fracture of the left sacral ala. He underwent a right hemicolectomy with ileocolic anastomosis and protective ileostomy and was immobilised in a body jacket orthosis for 3 months. The ileostomy was closed 3 months later. At 2-year follow-up, he is well.
安全带综合征是指在高速汽车碰撞后，被安全带约束的人可能出现的一系列损伤。伤者的躯干上可能会出现一条呈安全带形状的瘀伤。 Chance 骨折是一种水平状的椎体骨折，由脊柱过度前屈引起，导致椎体的三柱结构中断。其与腹腔内损伤相关联在儿童中较为罕见。一名处于青春期早期的男性在一场高能汽车事故中受伤。全身 CT 扫描显示前外侧腹壁裂伤和急性 L4 Chance 骨折。由于临床恶化进行的另一项 CT 扫描显示，升结肠穿孔是由肠系膜撕裂和左侧骶骨翼非移位性骨折引起的。他接受了右半结肠切除术、回肠结肠吻合术和保护性回肠造口术，并使用身体背心矫形器固定 3 个月。3 个月后关闭回肠造口。2 年随访时，他恢复良好。
