ABSTRACT
Death due to isolated injury to small bowel mesentery following abdominal trauma is rare. It is known that seatbelt trauma from motor vehicle accidents is the most common mechanism of mesenteric injury and that the mesentery of the small bowel is injured more frequently than that of the colon. Focal mesenteric infiltration associated with haemoperitoneum, particularly in the absence of solid organ injury, is highly suggestive of a mesenteric tear. In this report one such seat belt abdominal injury with subsequent mesenteric tear and bowel infarction with significant haemoperitoneum leading to death on the Operation table is being discussed. The main significance of this injury is delay and difficulty in diagnosis, especially when there is minimal signs and symptoms to warrant an exploratory laparotomy. Early detection and emergency surgical intervention when necessary are critical in improving the outcome of treatment.