{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:18:25Z","timestamp":1777936705895,"version":"3.51.4"},"reference-count":7,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Pediatr"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>With the use of seatbelts comes a unique injury profile that has been called \u201cthe seatbelt syndrome.\u201d The classically described \u201cseatbelt sign\u201d has become a pattern of injury, describing potential underlying damage. As a clinician, clues to the underlying damage follow a thorough physical examination including the removal of all clothing to locate abrasions and bruises to the skin that potentially follow a seatbelt pattern. Delayed presentation of an intra-abdominal injury in the setting of a seatbelt sign has been well documented; however, the question is how long to observe these patients. We present the case of a 17-year-old woman involved in a motor vehicle collision who presented to the emergency department (ED) hemodynamically stable with a lower abdominal wall seatbelt sign. Her initial imaging revealed only an abdominal wall contusion. She was admitted for observation. Approximately 12 h later she started developing abdominal pain, and by 14 h abdominal distention, with repeat imaging showing free fluid and free air. She was taken to the operating room for an exploratory laparotomy and was ultimately discharged back home on day 7.<\/jats:p>","DOI":"10.1177\/1179556519876635","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T06:23:31Z","timestamp":1569219811000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Perforated Small Intestine: A Case of a Delayed Presentation of an Intra-Abdominal Injury in a Pediatric Patient With a Seatbelt Sign"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1711-1140","authenticated-orcid":false,"given":"Gregory M","family":"Taylor","sequence":"first","affiliation":[{"name":"Indiana University School of Medicine, Ball Memorial Hospital, Department of Emergency Medicine, Muncie, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan P","family":"Zygowiec","sequence":"additional","affiliation":[{"name":"Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie C","family":"Wallace","sequence":"additional","affiliation":[{"name":"Beaumont Hospital, Botsford Campus, Department of Emergency Medicine, Farmington Hills, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn C","family":"Zelenka-Joshowitz","sequence":"additional","affiliation":[{"name":"Beaumont Hospital, Botsford Campus, Department of Emergency Medicine, Farmington Hills, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel F","family":"Chudler","sequence":"additional","affiliation":[{"name":"Beaumont Hospital, Botsford Campus, Department of Emergency Medicine, Farmington Hills, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,9,23]]},"reference":[{"key":"bibr1-1179556519876635","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.142764"},{"key":"bibr2-1179556519876635","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-015-0108-z"},{"key":"bibr3-1179556519876635","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(68)90451-0"},{"key":"bibr4-1179556519876635","first-page":"885","volume":"63","author":"Chandler C","year":"1997","journal-title":"Am Surg"},{"key":"bibr5-1179556519876635","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12506"},{"key":"bibr6-1179556519876635","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2016.01.015"},{"key":"bibr7-1179556519876635","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000131"}],"container-title":["Clinical Medicine Insights: Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179556519876635","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1179556519876635","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1179556519876635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:41:21Z","timestamp":1777693281000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1179556519876635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":7,"alternative-id":["10.1177\/1179556519876635"],"URL":"https:\/\/doi.org\/10.1177\/1179556519876635","relation":{},"ISSN":["1179-5565","1179-5565"],"issn-type":[{"value":"1179-5565","type":"print"},{"value":"1179-5565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]},"article-number":"1179556519876635"}}