Bicycle Handlebar Injury Research Articles

Blunt Trauma in Paediatric Patients - Experience from a Small Centre.

Despite great prevention efforts, blunt abdominal trauma still remains a leading cause of injury, especially in the paediatric population. Abdominal trauma is the main culprit of serious children's injury and the most common area of initially missed diagnosis with a fatal outcome. The purpose of this study was to determine the incidence, aetiology, grades of abdominal organ injuries, diagnosis, management and outcome of blunt abdominal trauma in a paediatric population. This is a retrospective study of 31 patients with isolated parenchymatous abdominal organs, treated in a single centre. Stable patients with no signs of peritonitis and insignificant changes in laboratory findings were managed conservatively. Unstable patients received surgery. The leading cause of injuries were traffic accidents (64.5%), followed by fall from a height (22.5%), bicycle handlebar injuries (6.45%), contact sport and child abuse (3.22% each). The majority of injured children (90.32%) were managed conservatively. Only three patients (9.68%) were operated on due to complete avulsion and organ smash, or devascularization of the injured organs. Diagnostic computed tomography (CT) scan examination was performed on 93.5% of patients. Few patients had grade I and grade V injuries, while the largest proportion of patients had grade III and IV injuries. The most frequently injured organs were the spleen and kidney. There was no mortality. The results emphasize that conservative treatment was appropriate for all stable patients with blunt abdominal trauma regardless of organ injury grade. The success of non-operative management depends upon proper patient selection. The choice of non-operative treatment should be based predominantly on physiological response, rather than grade injury on CT scan.

Isolated Traumatic Duodenal Rupture Due to Bicycle Handlebar Injury in an Adult Patient

Because of the well-developed abdominal musculature, the possibility of injury of the retroperitoneal organs such as the duodenum is not as high as that in children. Adult cases of isolated traumatic duodenal rupture caused by bicycle handlebar injury are extremely rare. We report a patient who experienced persistent abdominal pain after having a bicycle handlebar injury. Since the injury is hard to identify, abdominal computed tomography is performed to confirm the diagnosis. We also present a management flow chart to help physicians managing handlebar injuries in adults. (Hong Kong j.emerg.med. 2015;22:113-117)

Abdominal injuries involving bicycle handlebars in 219 children: results of 8-year follow-up.

Handlebar injuries are one of the most common causes of abdominal injuries in children. We aim to investigate the epidemiology of bicycle handlebar injuries and to emphasize the severity of the injuries. A retrospective analysis of children admitted to our hospital with abdominal injury related to bicycle handlebars was performed. A total of 219 children (187 males and 32 females) younger than 17 years were hospitalized for abdominal handlebar injuries between 2005 and 2013. The age range of the patients was 4-17 (mean 10.93 ± 3.68) years. Most patients had an imprint of the handlebar edge on their abdomen. The most common abdominal organ injury was liver laceration. 33 patients had pancreas injury and 13 patients had hollow organ injury. Most patients were treated conservatively. Surgery was performed in 24 patients. Hospital stay was 4-60 (mean 9.63 ± 13.37) days. Trend of bicycle handlebar trauma over this time period was related to the local floating population and economy. The most common abdominal organ injury was liver. Hollow organ injury required emergency exploratory laparotomy and the Roux-y anastomosis applied well in cases whose gastrointestinal tract damaged seriously. Pancreatic injury usually led to secondary pseudocyst. The percutaneous ultrasound-guided drainage of pancreatic pseudocyst was really an effective way. The trend in the amylase and lipase levels could reflect the pancreatic injury condition and predict prognosis. Early diagnosis and optimal care without delay may help to reduce the morbidity of injuries to the internal organs. Children with abdominal handlebar injuries should be treated with great care.

Serious Impact of Handlebar Injuries

Injuries from bicycles is a leading cause of trauma in children. We sought to investigate the epidemiology of bicycle handlebar injuries. A retrospective analysis of bicycle trauma treated at our institution was preformed. A total of 462 children younger than 17 years had bicycle trauma. Abdominal handlebar injuries, representing 9% of bicycle injuries, contributed to 19% of all internal organ injuries, and 45.4% of solid, 87.5% of hollow, 66.6% of vascular or lymphatic, and 100% of pancreatic injuries. Handlebar injuries were 10 times more likely to cause severe injury, yet more than half of the children were misdiagnosed at their initial presentation. Delayed diagnosis and longer hospital stays were observed in handlebar injuries to the abdomen. Physicians should be aware of the serious impact of bicycle handlebar injury to the abdomen. The mechanism alone should raise the suspicion of internal organ injury, and timely imaging and surgical consultation.

Laparoscopic Transgastric Cystogastrostomy in a 10-Year-Old Child

Abstract Introduction: Pancreatic pseudocysts are uncommonly seen in children.1 Trauma, most often injury by a cycle handle bar2–4 accounts for about 60%2 of these pseudocysts. Pancreatic pseudocysts are treated by internal drainage—either surgical (cystogastrostomy, cystojejunostomy) or endoscopically with stenting.5 Laparoscopic cystogastrostomy is safe and effective in the treatment of pediatric pancreatic pseudocysts and are performed by intragastric2,6 or transgastric routes.7 We report the technique of a successful laparoscopic transgastric cystogastrostomy in a 10-year-old boy with a post-traumatic pancreatic pseudocyst. Materials and Methods: This 10-year-old boy presented with a large lump in the upper abdomen. He had received treatment for traumatic pancreatitis sustained by a bicycle handle bar injury 2 months ago. A contrast CT abdomen revealed a 12×8-cm retrogastric pseudocyst of the pancreas. Operative Technique: The child was placed in a supine position after general anesthesia. A 10 F naso...

Isolated Jejunal Perforation Following Bicycle Handlebar Injury in Adults: A Case Report

The small intestine is the third in frequency intraperitoneal organ which is injured after blunt trauma of the abdomen. In most of the cases, this type of injuries is accompanied by other injuries, which make it more difficult to diagnose. Failure of diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Abdominal visceral injuries after flipping the handlebar of the bike are common in children. Such injuries can cause injury to both solid and hollow abdominal viscera. Unlike children, adults' abdominal visceral injuries after flipping the bike's handlebar are extremely rare. A 25-year-old man was admitted to our department due to progressively abdominal pain after an accident with the handlebar of his bike. The subsequent CT scan after per os administration of contrast medium revealed the presence of free intraperitoneal contrast. It is a rare case of jejunal perforation after flipping the handlebar of the bicycle which was treated by partial removal of the injured part of jejunum and end-to-end anastomosis. To the best of our knowledge this is the first time we describe such an injury with this mechanism to an adult.

小児自転車ハンドル外傷の特徴に関する検討－非ハンドル外傷例との比較－

小児自転車ハンドル外傷の特徴に関する検討－非ハンドル外傷例との比較－

Bilateral fractures of the hook of the hamate: a bicycle handlebar injury

Bilateral fractures of the hook of the hamate: a bicycle handlebar injury

Peri-cardiac arrest following blunt bicycle handlebar trauma to the iliac vessels: management of a rare case

Iliac vessel disruption following blunt trauma is an unusual presentation, particularly in the absence of an orthopaedic injury. We present the unique case of a 14-year-old boy who sustained a blunt bicycle handlebar impalement that resulted in complete transection of the external iliac artery and laceration of the external iliac vein, without a skeletal fracture. The patient deteriorated rapidly, entering hypovolaemic shock and peri-cardiac arrest at anaesthetic induction. Once haemodynamic stability was achieved, the lacerated external iliac vein was used to form an interposition graft to repair the external iliac artery. The rare occurrence and lack of familiarity with this injury, combined with the potential for fatal exsanguination if not swiftly diagnosed makes this case crucial to highlight. Blunt bicycle handlebar injury should carry a high suspicion of severe vascular compromise. If diagnosed this should be rapidly managed with aggressive resuscitation and revascularisation.

Sigmoid perforation and bucket-handle tear of the mesocolon after bicycle handlebar injury: a case report and review of the literature

We describe an unusual case of sigmoid colon perforation secondary to a bicycle handlebar injury. Because the patient presented 2 days after the initial injury, we suspected that the colon perforation was not the immediate result of the bicycle accident but, rather, was secondary to devascularization. At operation, we found a bucket-handle tear of the colonic mesentery, which was the patient's primary injury and cause of the perforated colon.

Traumatic abdominal wall hernia—a case report and literature review

We present a case report and comprehensive literature review of pediatric traumatic abdominal wall hernia caused by a blow from a bicycle handlebar. Traumatic abdominal wall hernia is a rare complication of bicycle handlebar injury. An awareness of this entity will help prevent a missed diagnosis. Operative repair is met with good outcome.

Blunt pancreatic trauma in children

To report our experience with blunt pancreatic trauma in pediatric patients and evaluate several various management strategies. Ten children admitted over the last 10 years with pancreatic blunt trauma were included in the present series. The average time from injury to hospital admission was 2.4 days. All injuries resulted from accidents: bicycle handlebar injuries (5), being kicked by a horse (2), falls from a height (2), and injury sustained during closure of an electric gate (1). Additional systemic and abdominal injuries were recorded in 7 patients. The amylase levels at the time of patient admission were normal in 3 patients, mildly raised in 4 patients, and elevated in 3 patients. Abdominal computed tomography was performed in 10 patients, ultrasonography in 5, and endoscopic retrograde cholangiopancreatography (ERCP) in 4. Pancreatic injuries comprised 4 grade I, 3 grade II, and 3 grade III injuries. Grade I and II injuries were successfully managed by conservative treatment. The 3 children with grade III trauma and pancreatic ductal injury in the neck (1), body (1), and tail (1) of the gland were surgically treated, having an uneventful postoperative stay of 8-14 days and no complications during the 1-year follow-up period. The present study supports early ERCP as an essential part of the initial patient evaluation when pancreatic transection is highly suspected.

Pancreatic trauma in children

To document the demographics, mechanisms and outcome of traumatic pancreatitis in children at a single large tertiary referral centre in Australia. We undertook a 10-year retrospective audit of children admitted to the Royal Children's Hospital, Melbourne, Australia with a hospital coded diagnosis which included pancreatic injury between 1993 and 2002. Data included patient demographics, source of admission, mechanism of injury, pancreatic complications, associated injuries, intensive care unit admission, results of any operative findings, results of any acute computed tomography and/or ultrasound imaging of pancreas, selected laboratory findings and length of stay. We identified two distinct groups of patients in the 91 documented cases of pancreatic trauma (median age 8.0 years, range 0.6-15.8 years; M:F 2.5:1.0): 59 had a history of abdominal trauma and elevated serum lipase but no CT or ultrasound evidence of pancreatic injury (Group A); 32 had a history of abdominal trauma, elevated serum lipase but also had CT scan and/or ultrasound evidence of pancreatic injury (Group B). Patients with "less severe" injury based on normal imaging had a lower initial lipase level [Group A, median 651 U/L (interquartile range 520-1,324) vs. Group B, 1,608 U/L (interquartile range 680-3,526); p = 0.005] and shorter admission time [Group A, 9.0 days (interquartile range 5.5-15.5) vs. Group B, 13.4 days (interquartile range 6.8-23.8); p = 0.04]. There were no differences with respect to mortality (Group A, 13.5% vs. Group B, 12.5%), but patients with evidence of injury on imaging were more likely to have surgical intervention (p = 0.0001). The single most important overall cause of pancreatic trauma was involvement in a motor vehicle accident as a passenger or pedestrian. However, in children with high-grade ductal injury, bicycle handlebar injuries were most common. Associated injuries were common in both groups. Significant pancreatic injury can occur in the absence of abnormality on medical imaging. Pancreatic trauma commonly occurs in the context of multiple injuries after motor vehicle accidents in children and bicycle handlebar injuries, especially in boys. Most children can be treated conservatively, with surgical intervention being limited to high-grade ductal injury.

Traumatic Transection of Pancreas at the Neck: Feasibility of Parenchymal Preserving Strategy.

BackgroundTo assess the feasibility and safety of a pancreas preserving operative technique in the management of isolated complete pancreatic neck transection following blunt abdominal trauma.MethodsTwo patients with isolated blunt fracture of the pancreatic neck underwent pancreas preserving procedure comprising of oversewing of the proximal pancreas and Roux-en-Y pancreatico jejunostomy to the distal remnant. A feeding jejunostomy tube was placed for postoperative nutritional support in these patients. Both patients received subcutaneous octreotide 300 µg/day.ResultsTheir ages ranged from 15 years to 20 years, mode of injury was bicycle handle-bar injury (n = 2). Both had pancreatic transection at neck in the line of superior mesenteric vessels. One had ascites. These patients had pancreas parenchyma preserving surgery – internal drainage of the left remnant in a Roux-en-Y jejunal loop. The postoperative course was uneventful in these and both are well on follow-up.ConclusionsPancreas preserving strategy – suture of head side of pancreas and an internal drainage of left remnant with a Roux-en-Y jejunal loop is feasible and safe and should be considered in selected cases. Substantial amount of normal pancreatic parenchyma is preserved.

A hidden danger of childhood trauma: Bicycle handlebar injuries

To evaluate childhood bicycle handlebar injuries. We evaluated retrospectively 14 patients who presented with bicycle handlebar injuries within a 3-year period. Bicycle injuries not caused by the handlebar were excluded. The mean age of the patients was 8.8 +/- 2 years (range, 5-12 years) and 79% were boys. The injuries comprised gastrointestinal perforation in 21%, traumatic abdominal hernia in 21%, and spleen laceration in 14%. The three children with intestinal perforation and the one with a penetrating abdominal injury underwent surgery, whereas the others were treated medically. An isolated traumatic abdominal hernia resolved spontaneously. There was no mortality. Although bicycle handlebar injuries occur at relatively low speeds, the transfer of energy from the end of the handlebar, with a small cross-sectional area, to a small field leads to intra-abdominal injuries that are more severe than predicted. Thus, bicycle handlebar injuries should be considered as a serious intraabdominal injury until proven otherwise.

A 6-year-old boy presenting with traumatic evisceration following a bicycle handle bar injury: a case report

We report the case of a 6-year-old boy presenting with small bowel evisceration following a fall onto a bicycle handle-bar. His case is presented, a review of the literature performed and interesting photos pre and post-op are presented.

Bicycle handlebar injuries in Western Australia: from imprints to abdominal wall hernias

Medical Journal of AustraliaVolume 189, Issue 5 p. 295-295 Letter Bicycle handlebar injuries in Western Australia: from imprints to abdominal wall hernias Parshotam K Gera, Corresponding Author Parshotam K Gera Fellow in Paediatric Surgery gerapk@rediffmail.com Princess Margaret Hospital for Children, Perth, WA.Correspondence: gerapk@rediffmail.comSearch for more papers by this authorAndrew P Barker, Andrew P Barker Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorIan Gollow, Ian Gollow Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorJillian Orford, Jillian Orford Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorSue Wicks, Sue Wicks Chief Executive Officer Kidsafe WA, Department of Health, Perth, WA.Search for more papers by this authorLiz Whan, Liz Whan Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this author Parshotam K Gera, Corresponding Author Parshotam K Gera Fellow in Paediatric Surgery gerapk@rediffmail.com Princess Margaret Hospital for Children, Perth, WA.Correspondence: gerapk@rediffmail.comSearch for more papers by this authorAndrew P Barker, Andrew P Barker Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorIan Gollow, Ian Gollow Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorJillian Orford, Jillian Orford Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this authorSue Wicks, Sue Wicks Chief Executive Officer Kidsafe WA, Department of Health, Perth, WA.Search for more papers by this authorLiz Whan, Liz Whan Paediatric Surgeon Princess Margaret Hospital for Children, Perth, WA.Search for more papers by this author First published: 01 September 2008 https://doi.org/10.5694/j.1326-5377.2008.tb02037.xCitations: 6Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume189, Issue5September 2008Pages 295-295 RelatedInformation

Conservative management of a traumatic abdominal wall hernia after a bicycle handlebar injury (case report and literature review)

‘Handlebar hernia' is the name given to a specific type of traumatic abdominal wall hernia (TAWH). It is an uncommon injury, caused by impact of the abdominal wall against a blunt object, often bicycle handlebars. We present a case of handelbar hernia, discuss its investigation and treatment and suggest that immediate surgical repair may not always be required.

Adult bicycle handlebar injury

This short article presents a case report of blunt trauma from a bicycle handlebar causing a significant and unusual abdominal injury in an adult. In this case, a 49-year-old woman who presented to the emergency department (ED) after developing gradually worsening abdominal pain 1 hour after a fall from her bicycle. She sustained a direct impact to her abdomen from her bicycle's handlebar. The work-up included an immediate trauma surgery consult and computed tomography scan of her abdomen and pelvis; laboratory data were unremarkable. The CT scan revealed a moderate to large hemoperitoneum and a possible small bowel rupture; surgical repair followed. The patient had an unremarkable postoperative course and was discharged home on the seventh postoperative day. The authors describe the nature of this case and encourage clinicians to maintain a high index of suspicion when evaluating an injured adult cyclist for these types of injuries.

A 7-year-old Boy with an Abdominal Wall Hernia and Ischemia of the Left Leg after a Bicycle Handle Bar Injury

Traumatic abdominal wall hernia is a rare event. We describe a 7-year-old boy in whom this rare injury was combined with a traumatic dissection of the external iliac artery. The hernia was corrected by primary repair, the dissection by resection of the injured part and endto-end anastomosis.