{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T19:59:50Z","timestamp":1793735990276,"version":"4.6.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T00:00:00Z","timestamp":1699142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002842","name":"Chiang Mai University","doi-asserted-by":"publisher","award":["CMU\u20102566"],"award-info":[{"award-number":["CMU\u20102566"]}],"id":[{"id":"10.13039\/501100002842","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This review and case study illustrates a patient with a complete transverse transection of a non\u2010pregnant uterus caused by blunt trauma associated with wearing a safety belt. The 31\u2010year\u2010old patient, who had a previous cesarean section, presented with impending hypovolemic shock caused by intra\u2010abdominal hemorrhage secondary to blunt trauma while wearing a safety belt. On physical examination, a transverse straight line of ecchymosis along the line of a fastened safety belt was noted without any other external injury. The operative findings revealed a complete transverse transection which had cut through the lower part of the non\u2010pathological, normal\u2010sized uterus with active bleeding and mild injury to the small bowel without active bleeding. Total hysterectomy and simple closure of the small bowel were performed with successful outcomes. We hypothesize that transection was caused by the enormous pressure produced by blunt trauma transmitted through the abdomen by the fastened safety belt and the weakness of the uterine wall caused by the previous low transverse cesarean section which facilitated the separation and extension to the entire wall. In conclusion, this case study provides the following learning points: (1) Enormous forces produced by a fixed fastened safety belt during a car accident can cause complete transverse transection of a normal\u2010sized, non\u2010pathological uterus, leading to life\u2010threatening intra\u2010abdominal hemorrhage. (2) A previous cesarean section may potentiate the transection, especially when the uterus is repositioned above the pelvic brim. (3) The gynecologic condition should also be included in the differential diagnoses in cases of intra\u2010abdominal hemorrhage. If highly suspected, gynecologists should be notified for early recognition and avoidance of delayed actions.<\/jats:p>","DOI":"10.1002\/ijgo.15227","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T07:19:12Z","timestamp":1699255152000},"page":"943-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Complete transverse transection of the normal\u2010sized non\u2010pregnant uterus associated with wearing a safety belt in abdominal blunt trauma: Narrative review and case study"],"prefix":"10.1002","volume":"165","author":[{"given":"Sasivimol","family":"Srisukho","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamtone","family":"Chandacham","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-6478","authenticated-orcid":false,"given":"Theera","family":"Tongsong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3998.367"},{"key":"e_1_2_10_3_1","first-page":"755","article-title":"The pregnant uterus\u2010external trauma and its consequences: annotated bibliography","volume":"21","author":"Levi AA","year":"1963","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1963.tb25110.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(64)90951-2"},{"issue":"10","key":"e_1_2_10_6_1","first-page":"1139","article-title":"Seat belt injury: case of complete transection of pregnant uterus","volume":"67","author":"McCormick RD","year":"1968","journal-title":"J Am Osteopath Assoc"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-196811000-00015"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(70)90283-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2007.06.042"},{"issue":"6","key":"e_1_2_10_10_1","article-title":"Management of traumatic uterine rupture in blunt abdominal trauma: a case report and literature review","volume":"12","author":"Suchecki G","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000916"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.02.025"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-008895"},{"issue":"2","key":"e_1_2_10_14_1","first-page":"304","article-title":"Rupture of the pregnant uterus caused by extra\u2010abdominal injury","volume":"27","author":"Asiner B","year":"1956","journal-title":"Bol Soc Cir Urug"},{"issue":"7","key":"e_1_2_10_15_1","first-page":"126","article-title":"Penetrating abdominal injury with damage to the pregnant uterus and intrauterine injury to the fetus","volume":"119","author":"Belousov AF","year":"1977","journal-title":"Vestn Khir Im I I Grek"},{"issue":"12","key":"e_1_2_10_16_1","first-page":"1153","article-title":"Explosive rupture of the pregnant uterus in the 29th week of pregnancy, caused by a serious external injury, in a 15\u2010year\u2010old girl","volume":"30","author":"Di Girolamo V","year":"1978","journal-title":"Minerva Ginecol"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0736-4679(95)02090-X"},{"issue":"8","key":"e_1_2_10_18_1","first-page":"683","article-title":"Torsion of a gravid uterus associated with maternal trauma. A case report","volume":"47","author":"Duplantier N","year":"2002","journal-title":"J Reprod Med"},{"issue":"1","key":"e_1_2_10_19_1","first-page":"60","article-title":"Incomplete uterine rupture, following blunt trauma to the abdomen: a case report","volume":"8","author":"Enakpene CA","year":"2005","journal-title":"Niger J Clin Pract"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1969.03160120062021"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1982.tb132319.x"},{"issue":"2","key":"e_1_2_10_22_1","first-page":"158","article-title":"Traumatic rupture of uterine fibroid: an uncommon cause of post traumatic haemoperitoneum","volume":"19","author":"Sule AZ","year":"2000","journal-title":"West Afr J Med"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.15227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:53:34Z","timestamp":1715529214000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.15227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,5]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/ijgo.15227"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.15227","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,5]]},"assertion":[{"value":"2023-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}