![]() ![]() This probably reflects the thinner and weaker abdominal wall of children compared to adults. Most handlebar hernias occur in children aged 4–14 years. While type III hernias involves bowel herniation generally attributed to deceleration injuries. Type II hernias are larger, resulting from higher energy impact such as motor vehicle accidents or fall from heights. Type I hernias involve small defect caused by lower energy impact by a localised object. Traumatic abdominal wall hernias are classified into three types. Blunt trauma can produce shearing of the musculature, fascia and peritoneum, while the skin remains intact. Ī traumatic abdominal wall hernia can occur when there is blunt or sharp trauma to the abdomen. This case has been reported in line with the SCARE criteria. We report a case of a handlebar hernia in a 10-year-old boy following a bicycle accident who subsequently went on to have a laparoscopic exploration and repair of his hernia. Management involves urgent surgical repair to avoid complications from incarceration or strangulation. Physical examination may be falsely reassuring and occult hernias may only be detected by abdominal computerised tomography (CT) or ultrasound (US) scans. Past reports have indicated that the presence of the “handlebar sign” is associated with increased risk of internal injury. A medline/pubmed search revealed 38 cases reported in the literature. Data on these hernias is limited with several case reports and few case series having been published. The first handlebar hernia was described by Landry et.al in 1956. Handlebar hernias result from direct blunt trauma by a handlebar-like object. Unstable patients or those with suspicion of hollow viscera perforation will require surgery as first approach.Traumatic abdominal wall hernias result from the disruption of the abdominal musculature and fascia secondary to blunt or sharp trauma. Non-surgical ma nagement is becoming more used for stable patients, achieving high success rates. A CT scan showed a he patic injury that was managed with non-surgical procedures, achieving resolution of the lesion after 8 weeks of follow-up.īlunt abdominal trauma caused by handlebar can be potentially serious in pediatric patients, since it may affect solid and hollow abdominal viscera. ![]() 3) 9-year-old boy admitted due to a hit with the bicycle handlebar on the abdomen area. ![]() After 6 weeks of follow-up, he presented resolution of the lesion and viability of the spleen. A CT scan showed a splenic injury with multiple lacerations and active bleeding that was treated with angioembolization. 2) 14-year-old boy seen at ED after a bicycle accident in which the handlebar hit him in the abdomen area. A la parotomy was performed and the duodenal perforation repaired. A CT scan showed signs of duodenal perforation. The aim of this study is to describe three cases of blunt abdominal trauma due to handlebar injury in children, in order to illustrate the different kinds of lesions, their presentation, and management.ġ) 11-year-old boy presented to Emergency Department (ED) after falling on a bi cycle handlebar, hitting his epigastric region. In Chile, there are no scientific articles about such accidents, their presentation and management. Bicycle accidents are a frequent cause of blunt abdominal trauma in children. ![]()
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