Seat belt-induced intestinal perforation.

OBJECTIVE: To determine whether a relationship exists between bowel perforation and seat belt use in patients presenting abdominal trauma after traffic accidents.

EXPERIMENTAL DESIGN: We prospectively studied every patient admitted to the emergency room with abdominal trauma after a traffic accident.

PATIENTS AND METHODS: We included every patient diagnosed (clinically, by ultrasound or computerized tomography or at laparotomy) as suffering intraabdominal injury. The degree of trauma was classified according to the Injury Severity Score, taking into account the number of abdominal injuries associated with mortality and seat belt use.

RESULTS: A total of 146 patients were studied. The spleen was the most frequently injured organ (n = 56). The mean Injury Severity Score was 19. Head injuries were more common among patients not wearing the seat belt. Thirteen cases of bowel perforation in patients who had been using the seat belt (p < 0.0001) were observed.

CONCLUSION: Seat belt use can decrease the mortality rate associated with traffic accidents. However, a significant increase exists in the incidence of bowel perforations among seat belt wearers, probably as a result of improper use.