Published in:
01-09-2020 | Classics in Abdominal Radiology
The abdominal seatbelt sign
Published in: Abdominal Radiology | Issue 9/2020
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The abdominal seatbelt sign (ASBS) refers to the characteristic linear transverse anterior abdominal wall contusion resulting from a compressive injury by the lap belt component of seatbelts occurring in patients involved in motor vehicle collisions (MVC). The abdominal seatbelt sign can be identified on physical examination (Fig. 1), on CT (Fig. 2) or both clinically and radiologically. It was first described in the Journal of Trauma in 1962 as part of a constellation of injuries encountered with seatbelt usage termed “the seatbelt syndrome” [1]. Following the introduction of three-point seatbelts in the 1970s, a concomitant diagonal contusion along the anterior chest wall caused by the shoulder belt component is frequently observed in this patient group (Fig. 3) [2]. Recognition of the CT presence of an ASBS is important due to its association with hollow viscus, mesenteric and lumbar spine injuries.
Fig. 1
Photograph demonstrating linear ecchymosis across the lower anterior abdominal wall of a patient involved in a MVC (restrained passenger)
Fig. 2
a Axial CT of the lower abdomen demonstrates contusion in the subcutaneous fat of the anterior abdominal wall at the level of the ASIS. b Coronal CT of the anterior abdominal wall shows the contusion extending horizontally along the anterior abdominal wall in the distribution of the lapbelt component of a seatbelt
Fig. 3
Metaphorical image depicting the distribution of a three-point seatbelt across a passenger. Public domain image available at: https://pixabay.com/vectors/fasten-seat-belt-buckle-up-belt-on-98794/. Accessed Nov 20, 2019
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