The seat belt aorta is an uncommon finding after a motor vehicle accident that may be initially overlooked due to concomitant injuries.

Clinical history:

(1) motor vehicle accident

(2) abdomiinal ecchymoses consistent with seat belt sign

(3) pulsatile abdominal mass

(4) acute arterial insufficiency in the lower extremities

(5) neurological deficit affecting the abdomen or lower extremities


Mechanism: direct compression of the abdominal aorta between the horizontal part of the seat belt and the vertebrae


The location in the aorta is most often distal to the inferior mesenteric artery.


Complications may include:

(1) dissection of the aortic intima

(2) thrombosis with or without embolization

(3) pseudoaneurysm

(4) rupture


In many cases an endovascular stent can be used to manage the condition.

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