Laparotomy: 

• mesenteric tears and vascular injuries

• infarcted terminal ileum necessitating partial ileocolectomy

• muscle tear of the rectum treated by high anterior resection

PR bleeding continued for 4 days and then settled.

Vascular, bowel and mesenteric injuries are often missed or under-diagnosed. Intermittent hemorrhage from vascular injuries is common. The terminal ileum is one of the relatively fixed areas of the bowel which are prone to injury.

Transverse subcutaneous fat-stranding is the radiological corollary of the seatbelt sign. The small L3 fracture is an indicator of the force of the trauma.