Zusammenfassung
Bei Gurtmarken am Abdomen muss auch an eine mögliche Bauchwandzerreißung gedacht werden. Die FAST-Sonographie und das Traumascan-CT stellen bei kreislaufstabilen Patienten mit Gurtmarken das Diagnostikum der Wahl dar. Aufgrund des Unfallmechanismus können zusätzliche intraabdominelle Verletzungen, Wirbelsäulenverletzungen und Aortenrupturen vorliegen. Bauchwandverletzungen ab Grad IV nach Dennis sollten chirurgisch versorgt werden. Aufgrund der zunehmenden Zahl adipöser Insassen und deren spezieller Verletzungsrisiken könnten aktive Rückhaltesysteme, neben der korrekten Positionierung das Verletzungsrisiko reduzieren.
Abstract
Abdominal seat belt marks can be an indication of abdominal wall rupture. The focused assessment with sonography for trauma (FAST) and computed tomography (CT) scanning are the diagnostic tools of choice in hemodynamically stable patients. The typical mechanism of trauma frequently leads to additional intra-abdominal injuries, spinal injuries and in some cases aortic rupture. Abdominal wall injuries of grade IV according to Dennis should be surgically treated. The increasing numbers of obese vehicle occupants and the resulting special risk of injury warrant optimization of technical restraint systems.
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Literatur
Dennis RW, Marshall A, Deshmukh H et al (2009) Abdominal wall injuries occurring after blunt trauma: incidence and grading system. Am J Surg 197:413–417
Cummins JS, Koval KJ, Cantu RV et al (2011) Do seat belts and air bags reduce mortality and injury severity after car accidents? Am J Orthop (Belle Mead NJ) 40:26–29
Agarwal N, Kumar S, Joshi MK et al (2009) Traumatic abdominal wall hernia in two adults: a case series. J Med Case Reports 3:7324
Inaba K, Kirkpatrick AW, Finkelstein J et al (2001) Blunt abdominal aortic trauma in association with thoracolumbar spine fractures. Injury 32:201–207
Netto FA, Hamilton P, Rizoli SB et al (2006) Traumatic abdominal wall hernia: epidemiology and clinical implications. J Trauma 61:1058–1061
Zarzaur BL, Marshall SW (2008) Motor vehicle crashes obesity and seat belt use: a deadly combination? J Trauma 64:412–419
Hill JR, Mackay GM, Morris AP (1994) Chest and abdominal injuries caused by seat belt loading. Accid Anal Prev 26:11–26
Stassen NA, Lukan JK, Carrillo EH et al (2002) Abdominal seat belt marks in the era of focused abdominal sonography for trauma. Arch Surg 137:718–722
Hickey NA, Ryan MF, Hamilton PA et al (2002) Computed tomography of traumatic abdominal wall hernia and associated deceleration injuries. Can Assoc Radiol J 53:153–159
Rodriguez ED, Bluebond-Langner R, Silverman RP et al (2007) Abdominal wall reconstruction following severe loss of domain: the R Adams Cowley Shock Trauma Center algorithm. Plast Reconstr Surg 120:669–680
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Interessenkonflikt. S. Bachmann, H. Schrem, P. Mommsen, R. Gaulke, J. Klempnauer, H. Bektas, C. Krettek und C. Zeckey geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Bachmann, S., Schrem, H., Mommsen, P. et al. Bauchwandzerreißung – Risiko Sicherheitsgurt?. Unfallchirurg 117, 962–964 (2014). https://doi.org/10.1007/s00113-013-2493-z
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DOI: https://doi.org/10.1007/s00113-013-2493-z