Seatbelt sign in a case of blunt XXXX ; what lies beneath it?

@entity1 @entity130 @entity254 @entity1661 @entity1410 @entity490 @entity1049
BACKGROUND: The reported incidence of hollow viscus injuries (HVI) in blunt @entity130 @entity1 is approximately 1  %. The most common site of injury to the intestine in blunt @entity1661 (BAT) is the small bowel followed by colon, with mesenteric injuries occurring three times more commonly than bowel injuries. Isolated @entity1049 is a rarely encountered condition. Clinical assessment alone in @entity1 with suspected intestinal or @entity130 after blunt @entity130 is associated with unacceptable diagnostic delays. CASE PRESENTATION: This is a case of a 31-year-old @entity1 , admitted to the emergency department after being the restrained driver, involved in a car accident. After initial resuscitation, focused assessment with sonography for @entity130 examination (FAST) was performed revealing a subhepatic mass, suspicious for intraperitoneal @entity1410 . A computed tomography scan (CT) that followed showed a @entity1410 of the mesocolon of the ascending colon with active extravasation of intravenous contrast material. An exploratory laparotomy was performed, hemoperitomeum was evacuated, and a subserosal @entity1410 of the cecum and ascending colon with areas of totally disrupted serosal wall was found. @entity1410 of the adjacent mesocolon expanding to the root of mesenteric vessels was also noted. A right hemicolectomy along with primary @entity254 was performed. @entity1 's recovery progressed uneventfully. CONCLUSION: Identifying an isolated @entity130 to the bowel or mesentery after BAT can be a clinical challenge because of its subtle and nonspecific clinical findings; meeting that challenge may eventually lead to a delay in diagnosis and treatment with subsequent increase in associated morbidity and mortality. Isolated @entity1049 is a rare finding after blunt @entity130 and usually accompanied by other intra-abdominal organ injuries. Abdominal 'seatbelt' sign, ecchymosis of the abdominal wall, increasing @entity490 and distension are all associated with HVI. However, the accuracy of these findings remains low. Diagnostic peritoneal lavage, ultrasound, CT and diagnostic laparoscopy are used to evaluate BAT. Although CT has become the main diagnostic tool for this type of injuries, there are few pathognomonic signs of @entity1049 on CT. Given the potential for devastating outcomes, prompt diagnosis and treatment is necessary and high clinical suspicion is required.
