Seat-Belt Syndrome as managed in Babcock University Teaching Hospital. A Case Report and Literature Review

This paper is a case report of a 54 year old woman that presented in our casualty with just "seat belt sign" following a road traffic injury. At laparotomy, she was found to have sustained disastrous internal/visceral injuries with torrential intraperitoneal haemorrhage from the surface of the liver caused by the seat belt. Frantic attempts at haemostasis were proving difficult and time wasting. The lacerated liver surface was then generously packed with absorbent abdominal mops which were left in-situ for 48hrs. A second-look operation 48 hrs later revealed satisfactory haemostasis of the bleeding surface of the left lobe of the liver OBJECTIVE: This paper is to highlight the wisdom in using "Damage Control" techniques to save a patient's life in an unsuspecting torrential bleed during laparotomy - especially in seatbelt injuries.

"Damage Control" implies doing the minimum, in the quickest time possible, to keep patient alive and coming back when patient is stable to deal with the pathology.

After 48hrs, a re-laparotomy was performed on the patient and it was found that complete haemostasis had been achieved. The packs were removed and abdomen closed in a single layer. The patient remained well till discharge after two weeks of hospitalisation and has remained well on follow up.

Seatbelts, although protective, can lead to complex injury patterns. Early detection and prompt management of the injuries is key to survival.