ABSTRACT
The authors report a number of rare traumatic lesions which can be described under the heading of "safety belt syndrome". The superficial haematoma which is invariably present ("seat belt sign") would seem to be a reliable indication of improper wearing of the seat belt which has been attached too loosely. The lesions seen were a vertebral arteriovenous fistula after cervical contusion, a closed rupture of a rectus abdominis muscle, associated with rupture of the homolateral renal artery and finally pelvi-ureteric disinsertion with laceration of the renal pelvis. It is important to be aware of such lesions which must be suspected in case of accident with a seat belt since the diagnosis is often difficult. The superficial haematoma is a valuable sign which should suggest the possibility of underlying deep lesions.
Subject(s)
Accidents, Traffic , Seat Belts/adverse effects , Abdominal Injuries/etiology , Adult , Angiography , Arteriovenous Fistula/etiology , Female , Humans , Male , Rupture , Ureter/injuriesABSTRACT
The authors present 3 cases where the diagnosis of ectopic insertion of the ureter, responsible for incontinence, had been missed: -- 2 cases of refluxing urethral insertions, including 1 case of single ureter, -- 1 case of vaginal ectopic ureter with duplicity. The authors stress that an ectopic insertion of the ureter can be asymptomatic until adulthood when it may present as simply as urinary stress incontinence. The diagnosis is suggested by a history of incontinence developing since childhood, accompanied by radiological signs of pyeloureteric duplicity or a small atrophic kidney. When the diagnosis is missed, successive surgical treatments are bound to fail, while excision of the renal segment drained by the ectopic ureter results in cure.
