The seat belt is the most important safety system in a motor vehicle and should always be worn to prevent serious injury. However, seat belt use has the potential for specific serious localized injury patterns, such as abdominal wall contusion, intra-abdominal injury, and Chance fracture, referred to as seat belt syndrome. Recent research finds that the patient who presents with an abdominal wall contusion and a Chance fracture is at high risk of intra- abdominal injury. Here, we present a regretful case of missed intra-abdominal injury in a patient who presented with an abdominal wall contusion and a Chance fracture. We then discuss the clinical implications of seat belt syndrome and review the pertinent literature. (J Acute Care Surg 2014;4:35-38)
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