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The seatbelt sign: early recognition may be life-saving
  1. Pamela Milito1,
  2. Stefano Siboni1,
  3. Emanuele Asti1,
  4. Luigi Bonavina1,2
  1. 1 Department of Surgery, IRCCS Policlinico San Donato, San Donato Milanese (Milano), Italy
  2. 2 Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
  1. Correspondence to Professor Luigi Bonavina, luigi.bonavina{at}

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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 …

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  • 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.