Traumatic gastric transaction: A case report

This report documents the first known pediatric survivor of seat-belt-associated gastric transection. An 11-year-old boy presented with abdominal ecchymoses after a motor vehicle accident. Physical and radiological examination determined the need for abdominal exploration. During the operation, a near-complete transection of the stomach was found, which was repaired by primary anastomosis. After an initially unremarkable recovery period, gastric stasis and pyloric obstruction developed. Radiologically and endoscopically, this was determined to be secondary to a traumatic distal vagotomy. Neither gastric transection nor traumatic vagotomy had been reported previously in the pediatric population with abdominal seat-belt injuries. This report demonstrates an exceptionally rare seat-belt-related injury, and its unusual postoperative complication. It also emphasizes the significance of the "seat-belt sign" in the assessment of motor vehicle-related blunt abdominal trauma, and outlines potential problems associated with the wearing of adult-designed lap belts by pediatric passengers. Copyright © 1996 by W.B. Saunders Company.