Aortic injury is very rare in blunt abdominal trauma, but dissection and thrombosis of the aorta from a seat belt is exceptional and could be explained by the joint action of opposing forces. Anatomically, the lesions could go from aor tic wall hematoma to complete rupture.
The authors describe a case of acute presentation with loss of both femoral pulses and signs of lower limb ischemia due to circumferential dissection of the intima at the aortic bifurcation and secondary thrombosis. Small bowel rupture was associated. The patient did well with bowel resection and simple suture of the intimal tear.
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