Ann Surg Treat Res.  2016 Aug;91(2):93-95. 10.4174/astr.2016.91.2.93.

Appendiceal transection associated with seat belt restraint

• Go SJ
• Sul YH
• Ye JB
• Kim JS

• KMID: 2344502
• DOI: http://doi.org/10.4174/astr.2016.91.2.93

Abstract

The seat belt is designed for safety in a motor vehicle and should be worn to prevent severe injuries. But, the seat belt itself can be an injury factor in combination with deceleration forces applied to fixation points of mobile viscera. Here, we present a 23-year-man with traumatic transection of the appendix, highly mobile viscera, following seat belt injury.

Keyword

Appendiceal; Transection; Seat belt

MeSH Terms

Appendix
Deceleration
Motor Vehicles
Seat Belts*
Viscera

Figure

• 

  Fig. 1 Ecchymosis on right lower quadrant along 3-point safety belts.

• 

  Fig. 2 Computed tomographic scan of the abdominopelvic cavity reveals small fluid collection (white dot) in abdominal cavity without free air and extravasation of contrast.

• 

  Fig. 3 Operative photograph showing the mesenteric tearing at the distal ileum.

• 

  Fig. 4 Operative photograph showing the proximal end of the transected appendix with 1-cm appendiceal stump attached to the base of cecum.

Reference

1. Garrett JW, Braunstein PW. The seat belt syndrome. J Trauma. 1962; 2:220–238.

2. Newman KD, Bowman LM, Eichelberger MR, Gotschall CS, Taylor GA, Johnson DL, et al. The lap belt complex: intestinal and lumbar spine injury in children. J Trauma. 1990; 30:1133–1138.

3. Bouassria A, Ibn Majdoub K, Yazough I, Ousadden A, Mazaz K, Taleb KA. Traumatic appendicitis: a case report and literature review. World J Emerg Surg. 2013; 8:31.

4. Serour F, Efrati Y, Klin B, Shikar S, Weinberg M, Vinograd I. Acute appendicitis following abdominal trauma. Arch Surg. 1996; 131:785–786.

5. Fowler RH. The rare incidence of acute appendicitis resulting from external trauma. Ann Surg. 1938; 107:529–539.

6. Denis R, Allard M, Atlas H, Farkouh E. Changing trends with abdominal injury in seatbelt wearers. J Trauma. 1983; 23:1007–1008.

7. Moslemi S, Forootan HR, Tahamtan M. Co-incidence of acute appendicitis and appendiceal transection after blunt abdominal trauma: a case report. Iran J Med Sci. 2013; 38:343–346.

8. Gatewood JW, Russum WJ. Injuries to the appendix secondary to blunt trauma. Am J Surg. 1956; 91:558–560.

9. Pillay SP, Baker LW. Appendiceal injuries: a report of 3 cases. S Afr Med J. 1977; 52:900–902.

10. Statter MB, Coran AG. Appendiceal transection in a child associated with a lap belt restraint: case report. J Trauma. 1992; 33:765–766.