Subclavian artery rupture (an unusual seat-belt injury)

A case of strangulation by a vehicle seat belt

A healthy 23-year-old man wearing a three-point seat belt suffered from a roll-over traffic accident. When the man was found, the fastened seat belt had loosened and the diagonal belt was tightened against the neck. Autopsy findings revealed ligature marks on the surface of the neck, hemorrhages in the muscles of the neck, petechial hemorrhages in palpebral conjunctivae and viscera, dark red liquid blood in the heart cavities and visceral congestion. We concluded that the man died of strangulation by the seat belt. In this case, the loose belt allowed the body to move and subsequently the diagonal belt applied external pressure to the neck while the car was rolling over. Although there have been several reports of neck injuries due to diagonal belts, this is the first report of strangulation by a properly used three-point belt in a roll-over vehicle accident.

Blunt injury to the subclavian artery

This paper reports two cases of closed injury to the subclavian artery, one resulting from avulsion and the other from compression from a seat-belt. Diagnosis may be delayed because of the absence of both haemorrhage and distal ischaemia. The surgical approach may be via a standard supraclavicular incision, but frequently a combined cervicothoracic approach is necessary.