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Seatbelt Syndrome in Children

Szadkowski, Matthew Arthur MD; Bolte, Robert G. MD

doi: 10.1097/PEC.0000000000001027
CME Review Article

The seatbelt syndrome describes an injury pattern infrequently seen in restrained passengers in motor vehicle collisions. It occurs when sudden deceleration forces coupled with compression of the lap belt around the abdomen causes abdominal wall bruising, intra-abdominal injuries, and spinal fractures. Infrequent and improper use of appropriate belt restraints in children has led to high risks for injury in this population.

We describe a case of the seatbelt syndrome with the uncommon finding of an associated posttraumatic intestinal obstruction. We also review the literature on the prevalence, risk factors, and types of injuries sustained by children with the seatbelt syndrome as well as discuss the indications for laboratory studies, abdominal imaging, surgical intervention, and further observation. Current recommendations for child seatbelt use and its effectiveness in preventing injury are also reviewed.

Clinical Professor (Bolte) and Clinical Assistant Professor (Szadkowski), Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.

The authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Reprints: Matthew Szadkowski, MD, 295 Chipeta Way, PO Box 581289, Salt Lake City, UT 84158 (e-mail:

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