Handlebar injury in children: Are we ignoring the signs?

Fernández, Rosa Fernández; Bragagnini, P.; Alvarez, Nora Elizabeth Rojas; Delgado, R. García; García, JM Pajares; Escartín, R.; Gracia, J.

doi:10.1016/j.epsc.2015.03.005

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…A diagnosis of blunt handlebar trauma is often delayed because there is typically no associated major blood loss. [4,8] Our patients were hemodynamically stable in the initial hours of the accident, and they only complained of mild-moderate abdominal pain. Complaints of even mild abdominal pain in isolated abdominal traumas and after such accidents should be taken seriously.…”

Section: Discussionmentioning

confidence: 82%

“…[10,15] Moreover, they can show false-positive and false-negative results. [3,7,8] The detection of the free intraperitoneal air with US is difficult, and its diagnostic capability is limited in patients who are uncooperative or obese. [14] CT has the disadvantage of additional radiation exposure, high cost, hazardous reinvestigations and is not useful for unstable patients and during the early hours after trauma.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Several studies have emphasized hidden, delayed, or ignored complaints to describe difficulties in diagnosing handlebar intestinal perforation. [3,4,5,6,7,8] Radiological examination is important for the diagnosis of blunt intestinal perforation; however, the utility of upright abdominal X-ray radiography (UAXR) is underestimated in these traumas, and patients are typically evaluated with more advanced and costly imaging modalities, such as ultrasound (US) and computed tomography (CT). [2,3,6,9] However, traditional radiography of the abdomen remains a valuable diagnostic modality for blunt intestinal perforation.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas

Mehmetoğlu¹

2019

Medicine

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Rationale: Intestinal perforations due to blunt abdominal handlebar trauma are difficult to diagnose. This report presents a retrospective analysis of 3 patients with intestinal perforations due to abdominal bicycle handlebar trauma who were diagnosed via upright abdominal radiography. Patients concerns: All the patients lost their balance while riding a bicycle for leisure and had fallen on the handlebar tip. The patients were initially misdiagnosed at different-level health centers despite various radiologic investigations performed. Diagnosis: The patients’ intestinal perforations were diagnosed via plain upright abdominal X-ray radiography (UAXR) in our institution. Interventions and outcomes: The children underwent exploratory laparotomy due to intestinal perforations. All the perforations were repaired either with primary closure or bowel resection and anastomosis with successful outcomes. Lessons: Pneumoperitoneum due to intestinal perforation can be diagnosed via UAXR with appropriate patient positioning and timing. This case series shows that to accurately diagnose intestinal perforations, upright plain X-ray should be routinely performed, carefully evaluated, and repeated in patients with enduring abdominal complaints.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas

Mehmetoğlu¹

2019

Medicine

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“…El tipo de lesiones causadas por estos accidentes puede ser diverso. En la región abdominal, la más frecuentemente afectada 7,8 , se describen lesiones de vísceras huecas y de órganos sólidos. Las lesiones de vísceras huecas pueden incluir perforación o hematoma a lo largo del tracto gastrointestinal y su mesenterio.…”

Section: Introductionunclassified

“…Tradicionalmente, el hallazgo de líquido libre o lesión de órgano sólido ha sido tratado con cirugía de emergencia 8 . Sin embargo, la alta morbilidad asociada ha favorecido el manejo conservador, que ha demostrado tener mejores resultados a corto y largo plazo 6 .…”

Section: Introductionunclassified

Trauma abdominal contuso por golpe con manubrio de bicicleta

et al. 2020

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Introducción: Los accidentes en bicicleta son una causa frecuente de trauma abdominal contuso en pediatría. En Chile no existen publicaciones científicas que traten sobre las lesiones abdominales por manubrio de bicicleta, su presentación y manejo.Objetivo: Describir tres casos clínicos de trauma abdominal contuso provocados por manubrio de bicicleta en niños, ilustrar las distintas lesiones observadas, sus formas de presentación y manejo.Casos Clínicos: 1) Paciente masculino, 11 años, consulta tras golpe con manubrio de bicicleta en epigastrio; en la Tomografía Computada (TC) de abdomen y pelvis se describió neumoretroperitoneo. Se realizó laparotomía exploradora, reparándose una perforación duodenal. 2) Paciente masculino, 14 años, consulta tras golpe en el hipocondrio izquierdo con el manubrio de la bicicleta; en la TC se evidenció fractura esplénica con múltiples laceraciones. Por la presencia de sangrado activo se trató con angioembolización, lográndose resolución de la lesión y viabilidad del órgano luego de 6 semanas de seguimiento. 3) Paciente masculino, 9 años, ingresó tras sufrir golpe con manubrio de bicicleta en el hipocondrio derecho. En TC se observó una laceración hepática, que fue manejada de forma expectante, con resolución de la lesión luego de 8 semanas de seguimiento. Todos los pacientes tuvieron una evolución favorable.Conclusión: El trauma abdominal contuso por golpe con manubrio de bicicleta puede ser potencialmente grave en pacientes pediátricos, pudiendo afectar órganos sólidos y vísceras huecas. El manejo no quirúrgico cada vez es más utilizado, logrando altas tasas de éxito en pacientes estables. Los pacientes inestables o en los que se sospeche perforación de víscera hueca, requerirán cirugía como primera aproximación.

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Road traffic accidents: a pictorial review

2018

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Road traffic accidents are still a major cause of morbidity and mortality. With well-established whole-body CT protocols in trauma, radiologists are an integral part of trauma diagnosis and management teams. Five well-recognized traumatic syndromes (seat belt syndrome, handlebar syndrome, scapulothoracic dissociation, dashboard syndrome, and brake pedal injury) with their frequent associated complications should be diagnosed precociously according to the accident mechanism to avoid diagnostic delays and poor prognosis even if the circumstances seem minor.

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Handlebar injury in children: Are we ignoring the signs?

Cited by 7 publications

References 25 publications

Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas

Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas

Trauma abdominal contuso por golpe con manubrio de bicicleta

Road traffic accidents: a pictorial review

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