Dell'Erba A, Di Vella G, Giardino N
Institute of Legal Medicine, University of Bari, Italy.
J Forensic Sci. 1998 Jan;43(1):215-7.
In traffic accident victims, the seat belt syndrome is a well known injury which rarely involves the common iliac artery due to its posterior anatomical position and to protection by the pelvis. We report a case of blunt abdominal trauma related to the type of seat belt worn. The trauma provoked subintimal haemorrhaging of the left common iliac artery, without skeletal lesions or other visceral injuries. Correct diagnosis was delayed for three months after the crash, when an angiogram was performed to investigate disabling claudication and vascular pulse change in the left leg. This arterial injury could have been related to the association of two different types of force created during the crash ("compression/deceleration-type mechanism") that might have produced shearing forces causing a vascular wall discontinuity and/or an intimal flap. The authors speculate that the vascular lesion was observed on the same (left) side as the fastening point of the seat belt (a lap-and-shoulder belt with a three-point attachment) where the shearing forces may have been most intense due to the junction between the lap strap and the diagonal shoulder belt.
在交通事故受害者中，安全带综合征是一种广为人知的损伤，由于其解剖位置靠后且受骨盆保护，很少累及髂总动脉。我们报告一例与所系安全带类型相关的钝性腹部创伤病例。此次创伤导致左髂总动脉内膜下出血，无骨骼损伤或其他内脏损伤。车祸发生三个月后，因对左腿致残性跛行和血管搏动变化进行血管造影检查才得以正确诊断。这种动脉损伤可能与车祸期间产生的两种不同类型的力（“挤压/减速型机制”）的联合作用有关，这两种力可能产生剪切力，导致血管壁连续性中断和/或内膜瓣形成。作者推测，血管病变发生在安全带固定点（三点式腰肩安全带）的同一侧（左侧），由于腰带和斜挎肩带的连接处，此处的剪切力可能最为强烈。
