WIDESPREAD USE of seat belts has resulted in a pronounced reduction of major and fatal injuries from automobile crashes.1-5However, if improperly positioned, seat belts may cause severe injury. In the case here presented, the belt was positioned so that the impact of the collision, plus the restraining action of the belt when the patient's body was thrown forward, caused sudden, severe compression of the upper abdominal viscera, with subsequent rib fractures and splenic rupture. This is believed to be the first reported case of splenic rupture caused by a lap-type automobile seat belt. Report of a Case A short, stocky 62-yr-old woman was a passenger in the front seat of an automobile which struck another automobile broadside at 35 mph. The driver, wearing no seat belt, was uninjured. When brought to the Ochsner Foundation Hospital Emergency Room, the patient complained of discomfort in the abdomen and left flank