Medico-Legal Considerations of Seat Belt Syndrome With Severe Abdominal Trauma: A Case Report and Literature Review

The seat belt sign (SBS) represents a unique injury profile consisting of ecchymosis and/or abraded skin in the distribution of a seat belt, evident after a road traffic accident (RTA). When accompanied by a radiological sign that illustrates internal injury, it is referred to as seat belt syndrome (SBSy). This case report highlights the importance of recognizing SBS and SBSy in medico-legal (ML) practice and helps physicians understand injury patterns found in seat belt wearers after an RTA. Accurate assessment of this trauma enables ML physicians to understand the mechanisms of the injuries and their life-threatening potential. We present the case of a 20-year-old male student who, while seated in the front seat wearing a seat belt, sustained injuries in an RTA and subsequently sought a medico-legal certificate (MLC) at the Timisoara Institute of Legal Medicine. The ML evaluation involved a detailed examination of external injuries and a thorough analysis of medical records. The most important aspect of this case is the ML approach to SBS, which has not been previously documented. We propose a three-step algorithm to facilitate accurate ML conclusions. This report provides valuable information to ML physicians and enhances the assessment of traumatic injuries in RTA victims by establishing a framework for addressing SBS.