• E Gruden, E Ragot, R Arienzo, A Revaux, M Magri, M Grossin, C Leroy, S Msika, and R Kianmanesh.
• Departments of General and Digestive Surgery, Louis-Mourier University-Hospital, AP-HP, Paris Diderot (Paris-7) University, 178 rue des Renouillers, Colombes cedex, France.
• Gastroen Clin Biol. 2010 Sep 1;34(8-9):499-501.

AbstractMesenteric trauma is one of the possible injuries caused by the use of seat belts in case of motor vehicle crash. We report here a rare case of rectal bleeding by rupture of a mesosigmoid haematoma. An emergent laparotomy revealed a mesosigmoid haematoma with a centimetric rectal perforation. The wearing of safety belts added some specific blunt abdominal trauma, which directly depends on lap-and-sash belts. Mesenteric injuries are found out up to 5% of blunt abdominal traumas. "Seat belt mark" leads the surgical team to strongly suspect an intra-abdominal trauma. When "seat belt mark" sign is found, in patients with mild to severe blunt car injuries, CT-scan has to be realised to eliminate intra-abdominal complications, including mesenteric and mesosigmoid ones. In case of proved mesenteric haematoma associated to intestinal bleeding, a surgical treatment must be considered as first choice. Conservative approach remains possible in stable patients but surgical exploration remains necessary in unstable patients with active bleeding.Copyright © 2010 Elsevier Masson SAS. All rights reserved.

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