シートベルト着用に起因する小腸破裂症例の検討

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  • RUPTURE OF THE SMALL INTESTINE IN DRIVERS WHO BUCKLED UP SAFETY BELT

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From January 1997 to May 1999, six cases of rupture of the small intestine relating to the buckled safety belt were encountered in the hospital. Their ages ranged from seven to 65 years and the male-to-female ratio was two to four. When injured at traffic accident, two patients were driving and other four patients were sitting on a passenger seat. Three patients were operated on immediately after admission, but in other three patients, it took 1 to 3 days until performing operations due to delayed diagnosis. The reasons included that conservative therapy yielded a remission of abdominal symptoms after admission and signs of peritonitis were obscure. The rupture sites were the jejunum in five cases and the ileum with seromuscular tear of the cecum in one case. Two cases of jejunal rupture were associated with mesenteric tears. All patients were performed simple sutures of the ruptured bowel. Their postoperative courses were uneventful, however, 7-year-old boy was re-admitted due to intestinal obstruction, and was operated on again.<br> Since the safety belt is not necessarily effective to protect the abdomen, more effective restraint systems are needed. Patients with blunt abdominal trauma, especially those who buckled up safety belt, must be admitted for careful examination as well as close clinical observation not to miss the well-timed operation for the small bowel injury.

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