@article{ref1,
title="Pediatric traumatic abdominal wall hernia as a component of the seatbelt syndrome: a case series and review of the literature",
journal="Pediatric surgery international",
year="2021",
author="Sorber, Rebecca and Pedroso, Felipe E. and Cappiello, Clint D. and Kunisaki, Shaun M. and Jelin, Eric B. and Rhee, Daniel S.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Blunt impact-induced traumatic abdominal wall hernia (TAWH) is an uncommon pediatric surgical problem classically associated with handlebar injury but  increasingly seen with seatbelt use in motor vehicle collisions (MVC). Herein we  describe the largest case series of pediatric TAWH to date and review the literature  to establish the unique syndromic characteristics of MVC-associated TAWH. <br><br>METHODS:  In this single-institution series, we discuss four pediatric patients, all with  seatbelt-associated TAWH after high-speed MVC characterized by full-thickness  disruption of the lateral abdominal wall. We then performed a review of the  literature to identify additional pediatric MVC-associated TAWH and define the  characteristics of patients who sustained this unique injury. <br><br>RESULTS: In addition  to the four patients in our case series, five additional pediatric patients  presenting with TAWH after restrained MVC were identified in the literature. Of  these nine patients, eight (89%) presented with an obvious seatbelt sign  (bruising/laceration to the abdominal wall). Six (67%) had associated injuries  typical of the seatbelt syndrome, including four spinal flexion injuries (44%) and  five bowel injuries requiring repair or resection (56%). Overall, 56% of  seatbelt-associated TAWH occurred in children with a BMI percentile > 95%. <br><br>CONCLUSIONS: In this case series and literature review, we note a high rate of  seatbelt syndrome injuries in pediatric patients presenting with TAWH after  restrained MVC. Suspicion for TAWH should be high in children presenting with a  seatbelt sign and should trigger a low threshold for pursuing additional axial  imaging. LEVEL OF EVIDENCE: Level IV; case series.<p /> <p>Language: en</p>",
language="en",
issn="0179-0358",
doi="10.1007/s00383-020-04796-9",
url="http://dx.doi.org/10.1007/s00383-020-04796-9"
}