Seat belt injury to the inguinal region presenting with hemorrhagic shock

Background Seat belts uncommonly result in various injuries to the abdominal area, such as mesenteric tears, bowel perforations, and abdominal aortic ruptures. We describe a case of a massive subcutaneous hematoma causing hemorrhagic shock from significant lacerations to the inguinal region, related to the use of a seat belt. Objectives To describe a seat belt injury to the inguinal region that presented with a massive subcutaneous hematoma, and to speculate about the mechanism that caused the injury. Case Report A 60-year-old woman, who was wearing a seat belt, was brought to our tertiary hospital Emergency Department after a head-on motor vehicle accident. The patient had vascular injury around the right inguinal region resulting in hemorrhagic shock. Transcatheter arterial embolization (TAE) was successfully performed to stop the bleeding. Conclusion Seat belts can cause serious injury to the inguinal region, mainly due to shearing forces. In addition to gauze packing, TAE was used effectively to control the hemorrhage in this patient.