Figure 1b. Lap belt injury in a 16-year-old girl after a motor vehicle accident in which she was a backseat passenger. A Chance fracture of the third lumbar vertebra was seen on radiographs and scout CT scans. (a) Photograph shows prominent lap belt ecchymosis. (b) CT scan shows disruption of the rectus muscles and a diffuse traumatic hernia of the anterior abdominal wall (arrows). Fluid at the mesenteric root and moderate free intraperitoneal fluid were noted on other sections. No free intraperitoneal air or bowel wall thickening was seen. At surgery, multiple mesenteric defects were found with extensive areas of devascularization of the small intestine, cecum, and sigmoid colon. Most of the intestine was resected.