Sir.—Delayed complications of small-bowel injuries after automobile accidents are difficult to diagnose since the clinical and roentgenographic findings are often inconclusive. We report a late complication, jejunal stenosis. To our knowledge, only one similar case has been reported.1
Patient Report.—A 15-year-old girl presented with severe abdominal and back pain after an automobile accident several hours earlier. She was a rear-seat passenger and was wearing a lap-type seat belt. The patient was alert, but a severe drop in her hematocrit value to 0.23, a systolic pressure of 80 mm Hg, and a pulse rate of 120 beats per minute were noted. A large hematoma over the lumbosacral area and a "seat belt" shaped bruise over the lower abdomen were present. There was severe abdominal tenderness to palpation, but the abdomen was not distended, with normal bowel sounds.
The patient received several units of blood and fluid replacement. Following
WEINBERG B, WAGNER LD, PERALTA VE, BARNETT SH, SHAH KD. Jejunal Stenosis: A Delayed Complication of Lap-Type Seat Belt Injury. Am J Dis Child. 1989;143(12):1392–1394. doi:10.1001/archpedi.1989.02150240014007
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