シートベルト損傷による胃破裂の1例

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  • GASTRIC RUPTURE DUE TO SEAT BELT INJURY

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Gastric rupture due to seat belt injury is rare. We experienced such a case of gastric rupture which was etiologically interesting. A 40-year-old woman was admitted to the hospital following an automobile accident. She was wearing a lap and shoulder type seat belt and was compressed her lower abdomen by the belt at the collision. After admission, her abdomen gradually showed muscular defence and tender-ness. Computed tomography of the abdomen revealed a low density area around the stomach, but plain abdominal and chest radiography could not show any intraabdominal free gas. At laparotomy, omental bursa was filled with a large quantity of remnants of foods and the stomach had been lacerated across the longitudinal axis at the body near the greater curvature. Gastric wall was transected from the serosa through mucosa. There was no other injury on the serosa, so we closed the laceration and did not resect the stomach. In this case, we suppose that seat belt compressed the lower intestinal tract, and it made the functional closed loop at the stomach. Bursting was the result of a closed loop obstruction increasing intraluminal pressure.

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