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A 47-year-old woman with body mass index (BMI) of 27kg/m2 was involved in a high speed (60 mph) frontal car accident. She was the driver wearing seatbelts and the airbag deployed. There was a transient loss of consciousness before arrival to the emergency department. On presentation, the patient was breathing spontaneously and was haemodynamically stable: blood pressure was 125/80 mm Hg, heart rate 77 beats/min and the Glasgow Coma Scale (GCS) was 15. Physical examination of the abdomen revealed mild generalised tenderness. A linear ecchymosis (seatbelt sign) was present at the level of the left superior iliac spine extending across the right flank. Laboratory tests showed normal C reactive protein, increased creatine kinase (908 U/L) and white cell count (0.00001829×109 …
Contributors PM, SS and EA collected the data and images, and wrote the first draft of the manuscript. LB revised the manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.