Pediatric traumatic abdominal wall hernia as a component of the seatbelt syndrome: a case series and review of the literature
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Jan 2021 · 1 min read
In brief
In brief
Case series of nine pediatric patients with traumatic abdominal wall hernia (TAWH) after restrained motor vehicle collisions reveals high association with seatbelt syndrome injuries including spinal flexion injuries (44%) and bowel injuries (56%). Most patients presented with visible seatbelt sign, and over half had BMI >95th percentile, suggesting need for low threshold for axial imaging in children with seatbelt marks after MVC.
Written by the GCMD Library team from the article.
Abstract
Background
Blunt impact-induced traumatic abdominal wall hernia (TAWH) is an uncommon pediatric surgical problem classically associated with handlebar injury but increasingly seen with seatbelt use in motor vehicle collisions (MVC). Herein we describe the largest case series of pediatric TAWH to date and review the literature to establish the unique syndromic characteristics of MVC-associated TAWH.
Methods
In this single-institution series, we discuss four pediatric patients, all with seatbelt-associated TAWH after high-speed MVC characterized by full-thickness disruption of the lateral abdominal wall. We then performed a review of the literature to identify additional pediatric MVC-associated TAWH and define the characteristics of patients who sustained this unique injury.
Results
In addition to the four patients in our case series, five additional pediatric patients presenting with TAWH after restrained MVC were identified in the literature. Of these nine patients, eight (89%) presented with an obvious seatbelt sign (bruising/laceration to the abdominal wall). Six (67%) had associated injuries typical of the seatbelt syndrome, including four spinal flexion injuries (44%) and five bowel injuries requiring repair or resection (56%). Overall, 56% of seatbelt-associated TAWH occurred in children with a BMI percentile > 95%.
Conclusions
In this case series and literature review, we note a high rate of seatbelt syndrome injuries in pediatric patients presenting with TAWH after restrained MVC. Suspicion for TAWH should be high in children presenting with a seatbelt sign and should trigger a low threshold for pursuing additional axial imaging.
Level of evidence
Level IV; case series.