Seat belt syndrome is caused by a different mechanism: A case report.

INTRODUCTION AND IMPORTANCE: Seat belt syndrome is associated with multiple visceral injuries and vertebral burst fractures. Small Intestinal perforations are seen in 5-15 % of blunt abdominal trauma. In our case, we will report a case that presented small intestinal perforation and thoracic vertebral fracture caused by a different mechanism.

CASE PRESENTATION: Previously healthy 48-year-old male presented to the emergency department following falling from 15 feats height. He was a paraplegic with a sensory level at T12. He did not have a clinical feature of spinal shock. He was complaining of epigastric and central abdominal pain and tenderness and was diagnosed to have a proximal Jejunal perforation associated with an unstable fracture of T12 causing spinal compression. Open intestinal repair followed by a posterior spinal exploration and pedicle screw fixation done.

CLINICAL DISCUSSION: Violent injury due to different mechanisms can have similar injuries to Seat belt syndrome. Ultrasonography is used to detect pneumoperitoneum, but the Contrast study is the gold standard to detect visceral injuries. The surgical approach to visceral injury depends on the patient's condition. But the laparoscopic approach has a more favorable postoperative outcome than open access.

CONCLUSION: Intestinal perforations associated with the neurological deficit are difficult to identify in an initial clinical assessment. Thoracolumbar fractures can associate with small bowel injuries during high-velocity trauma. Early identification and repair of the intestinal injury are important to prevent devastating complications and to improve neurological recovery after spinal surgery.