Seat belt injuries are classified as blunt trauma. A number of injuries are more likely in the context of blunt trauma, one of which is a mesenteric tear.
The sigmoid colon is one part of the gastro-intestinal tract with a relative mobile mesentery with significantly vasculature contained within. With a de-acceleration injury it is vulnerable to tearing.
Given the force of impact other injuries, such as solid organ lacerations, are often associated.
A prior FAST scan by a clinician in A&E identified free fluid in the upper abdomen. This was confirmed to be haemoperitoneum on CT.
Active bleeding may be evident on CT in the form of contrast extravasation or if multiphase imaging is acquired, the associated pooling of contrast at the site of haemorrhage.
Surgical exploration in this case confirmed the radiological observation of acute haemorrhage from the distal branchs of the inferior mesenteric artery in the sigmoid mesocolon.