Automobile safety belts rarely cause intra-abdominal injury, especially if properly worn. Only 23 cases have been previously reported in the literature. When such injury does occur, evidence of it may not be apparent when the patient is first seen. The physician must be alert to this possibility. Physical findings, blood studies, paracentesis, and diagnostic roentgenograms may lead to the diagnosis or indicate the necessity for an exploratory laparotomy.
LeMire JR, Earley DE, Hawley C. Intra-abdominal Injuries Caused by Automobile Seat Belts. JAMA. 1967;201(10):735-737. doi:10.1001/jama.1967.03130100033009