The case that submarining caused perforation of ileum

DOI
  • KONDOU Hiroki
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine
  • INOUE Kaoru
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine
  • AKASAKA Yoshihisa
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine
  • ICHIOKA Hiroaki
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine
  • BANDOU Risa
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine
  • IKEGAYA Hiroshi
    Department of Forensic Medicine, Graduate School of Medicine, The Kyoto Prefectural University of Medicine

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Other Title
  • サブマリン現象により回腸穿孔をきたした症例

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Abstract

Since wearing a seatbelt while driving has become obligatory, the death rate by traffic accidents has decreased. On the other hand, submarining caused by motor vehicle collisions in common. Though there are few reports which study the incidence of submarining in detail, the mechanism of submarining is known as a dysfunction of the lap belt. Submarining is more likely when passengers are small of stature or are in the rear seat. We present a case in which submarining caused intestinal perforation and resulted in death with peritonitis. The cadaver was a 70-year-old female. She was 147 centimeters in height and weighed 48 kilograms. Her vehicle ran onto the sidewalk and crashed into a wall at 20-30 kilometers an hour. She was taken to the emergency hospital and underwent X-ray examination. Since no evident fractures were indicated by this examination, she was diagnosed with a whole-body contusion and went home. After two days, she started vomiting and went into cardiopulmonary arrest. She was taken to hospital and her death was confirmed. The autopsy revealed perforation of the ileum and peritonitis. This was a rare case of submarining causing intestinal injury at a relatively low speed. Through this case, we can see the difficulty of evaluating traffic injuries in a new light.

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