Çocukta emniyet kemeri sendromu, gecikmiş bağırsak yaralanmaları olan olgu sunumu ve literatürün gözden geçirilmesi
Abstract
Amaç: Bu olgu sunumunun, emniyet kemeri olası yaralanmalarının, erken teşhisine yardımcı olacağına inanıyoruz. Emniyet kemerine bağlı çocuk hastada gecikmiş ileal perforasyonları olan hastanın klinik bulgu ve semptomları eşliğinde sunduk.
Olgu: 10 yaş erkek hasta araç içi trafik kazasında karaciğer grade 1 laserasyonu nedeniyle yoğun bakıma takip için yatırıldı. Hemodinami stabildi, çekilen tomografide perforasyon yokken, takibin 2. Günü abdominal distansiyon ve hassasiyet nedeniyle yapılan laparotomide ileal barsakda iki noktada kuş gözü perfosyan primer tamir edildi.
Sonuç: Emniyet kemerine bağlı abdominal ekimozu olan hastalarda sonuç olarak, akut dönemde negatif abdominal BT taramaları mevcut olsa da, yüksek enerjili çarpışmalardaki araç kazalarında, olası intraabdominal organ hasarı akılda tutulmalı ve inatçı ağrı ve hassasiyet varlığında, emniyet kemeri sendromunu akılda tutmak, hekimi erken tanı ve tedaviye götüreceğine inanıyoruz.
References
- 3. Budd JS. The effect of seat belt legislation on the incidence of sternal fractures seen in the accident department. Br Med J (Clin Res Ed) 1985;291:785.
- 4. McCarthy M. The benefit of seat belt legislation in the United Kingdom. J Epidemiol Community Health 1989;43:218-22.
- 5. Hamilton JB. Seat-belt injuries. Br Med J. 1968;4(5629):485-6.
- 6. Bhagvan S, Turai M, Holden A, Ng A, Civil I. Predicting hollow viscus injury in blunt abdominal trauma with computed tomography. World J Surg. 2013;37(1):123-6.
- 7. Dodds M, Gül R. Noelle cassidy late-diagnosed seat-belt syndrome: a second cahance? İnj Extra 2006;37:25-7.
- 8. Drucker NA, McDuffie L, Groh E, Hackworth J, Bell TM, Markel TA. Physical Examination is the Best Predictor of the Need for Abdominal Surgery in Children Following Motor Vehicle Collision. J Emerg Med. 2018;54(1):1-7.
- 9. Okeke RI, Lok J, Keranalli P, et al. A case of delayed cecal perforation after abdominal (seat belt) injury. Cureus. 2022;14(8):e27901.
- 10. Tatekawa Y. A case of seat belt-induced small bowel rupture and Chance fracture accompanied by elevated serum amylase. J Surg Case Rep. 2021;2021(7):rjab315.
- 11. Jones EL, Stovall RT, Jones TS, et al. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg. 2014;76(4):1020-3.
- 12. Chandler CF, Lane JS, Waxman KS. Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury. Am Surg. 1997;63(10):885-8.
- 13. Santschi M, Echavé V, Laflamme S, McFadden N, Cyr C. Seat-belt injuries in children involved in motor vehicle crashes. Can J Surg. 2005;48(5):373-6.
- 14. Brofman N, Atri M, Hanson JM, Grinblat L, Chughtai T, Brenneman F. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. Radiographics. 2006;26(4):1119-31.
Abstract
Aims: We believe that this case report will help in the early diagnosis of possible seat belt injuries. We present a case of delayed ileal perforations in a pediatric patient with clinical signs and symptoms.
Case: A 10-year-old male patient was admitted to the intensive care unit for follow-up due to a grade 1 laceration of the liver in a vehicular traffic accident. Hemodynamics were stable and there was no perforation on CT scan. On the 2nd day of follow-up laparotomy due to abdominal distension and tenderness, primary repair of bird's eye perforation was performed at two points in the ileal intestine.
Conclusions: In conclusion, although negative abdominal CT scans are available in patients with seat belt-related abdominal ecchymosis in the acute phase, we believe that possible intra-abdominal organ damage should be kept in mind in vehicle accidents in high-energy collisions and keeping seat belt syndrome in mind in the presence of persistent pain and tenderness will lead the physician to early diagnosis and treatment.
References
- 3. Budd JS. The effect of seat belt legislation on the incidence of sternal fractures seen in the accident department. Br Med J (Clin Res Ed) 1985;291:785.
- 4. McCarthy M. The benefit of seat belt legislation in the United Kingdom. J Epidemiol Community Health 1989;43:218-22.
- 5. Hamilton JB. Seat-belt injuries. Br Med J. 1968;4(5629):485-6.
- 6. Bhagvan S, Turai M, Holden A, Ng A, Civil I. Predicting hollow viscus injury in blunt abdominal trauma with computed tomography. World J Surg. 2013;37(1):123-6.
- 7. Dodds M, Gül R. Noelle cassidy late-diagnosed seat-belt syndrome: a second cahance? İnj Extra 2006;37:25-7.
- 8. Drucker NA, McDuffie L, Groh E, Hackworth J, Bell TM, Markel TA. Physical Examination is the Best Predictor of the Need for Abdominal Surgery in Children Following Motor Vehicle Collision. J Emerg Med. 2018;54(1):1-7.
- 9. Okeke RI, Lok J, Keranalli P, et al. A case of delayed cecal perforation after abdominal (seat belt) injury. Cureus. 2022;14(8):e27901.
- 10. Tatekawa Y. A case of seat belt-induced small bowel rupture and Chance fracture accompanied by elevated serum amylase. J Surg Case Rep. 2021;2021(7):rjab315.
- 11. Jones EL, Stovall RT, Jones TS, et al. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg. 2014;76(4):1020-3.
- 12. Chandler CF, Lane JS, Waxman KS. Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury. Am Surg. 1997;63(10):885-8.
- 13. Santschi M, Echavé V, Laflamme S, McFadden N, Cyr C. Seat-belt injuries in children involved in motor vehicle crashes. Can J Surg. 2005;48(5):373-6.
- 14. Brofman N, Atri M, Hanson JM, Grinblat L, Chughtai T, Brenneman F. Evaluation of bowel and mesenteric blunt trauma with multidetector CT. Radiographics. 2006;26(4):1119-31.
Details
| Primary Language | English |
|---|---|
| Subjects | Pediatric Surgery, Surgery (Other), Pediatric Intensive Care |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | March 28, 2025 |
| Submission Date | December 31, 2024 |
| Acceptance Date | February 7, 2025 |
| Published in Issue | Year 2025 Volume: 13 Issue: 1 |
