A case of seat belt-induced small bowel rupture and Chance fracture accompanied by elevated serum amylase

Abstract

We report herein our experience with a 10-year-old girl who incurred injuries consistent with seat belt syndrome. The patient was involved in a low-speed motor vehicle accident while restrained in a three-point belt (shoulder and lap belts). She complained of abdominal pain and developed tenderness and abdominal guarding. On admission, enhanced computed tomography (CT) demonstrated a fluid collection in the pelvis and a fractured vertebra in the lumbar spine. The following day, her C-reactive protein and serum amylase levels were elevated and plain CT demonstrated free air in the left side of the abdominal cavity. A ruptured jejunum was detected on laparoscopy. The involved segment of intestine was resected and an end-to-end anastomosis performed. She had an uneventful post-operative course. On post-operative day 14, she was transferred to another facility to undergo therapy for her spinal fracture. After completing conservative therapy, she was discharged 5 weeks after the initial injury.