Pancreatic Injury and Delayed Large Intestinal Perforation Caused by a Seat Belt Injury: A Case Report

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 24; no. 6; pp. 1091 - 1095
• Main Authors: Yamasita, Susumu, Honda, Masahiro, Nakahara, Takasi, Maekawa, Tsuyosi, Kaneko, Tadashi, Fujita, Motoki, Kaneda, Kotaro, Tsuruta, Ryosuke
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2004; 日本腹部救急医学会
• Subjects: シートベルト外傷; 膵損傷; 遅発性大腸穿孔
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.24.1091

We report a pancreatic injury and delayed large intestinal perforation caused by a seat belt injury. An 18 -year-old woman was admitted to our emergency center after being involved in a traffic accident. She had sustained a type I pancreatic injury, a type Ia hepatic injury, fractures of the 7-9th right ribs, and a fracture of the 12th thoracic vertebra, without any severe abdominal symptoms or related findings. On the 14th day of hospitalization, a tendency towards abdominal distension was noted. Acute peritonitis caused by gastroin-testinal perforation was diagnosed based on an abdominal computed tomography examination and an abdominal cavity exploratory puncture. An emergency surgery was performed, and perforated points with remarkable hyperplasia were found in the wall of the transverse colon. A partial resection of the transverse colon and a colostomy were performed. She did not experience any remarkable postoperative complications and was transferred to an affiliated hospital on the 37th day of hospitalization. The possibility of delayed intestinal perforations must be kept in mind when treating cases with blunt abdominal injuries.