Traumatic abdominal wall hernia: an unusual bicycle handlebar injury

Abstract

Traumatic hernia of the abdominal wall is rare. The mechanism of injury can be severe such as a motor vehicle accident or relatively minor such as a fall onto a bicycle handlebar. In children traumatic abdominal wall hernia can occur even after relatively minor trauma and these cases typically have no associated intra-abdominal injury. We report a traumatic hernia of the anterior abdominal wall in a 7-year-old boy following a fall from a bicycle. A review of the literature revealed only nine similar reports. The presence of localised pain, bruising, and a reducible swelling or a cough impulse suggests the diagnosis. Primary repair with prosthetic material is the preferred treatment.

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

“…For this reason, it has been referred to as "handlebar hernia" [1]. These have been reported in both children and adults [1][2][3][4][5][6][7][8][9][10][11]. The first reported case of TAWH in a child was in 1906 by Selby [1], who reported a hernia because of impact against the handle of a wheelbarrow.…”

Successful Conservative Treatment of a Bicycle-Handlebar Hernia: Report of a Case

“…Computed tomography and US were useful for detecting the disruption of the abdominal wall musculature or the prolapsed intestine. [1][2][3][4][5][6][7][8][9][10][11] In our patient, no prolapsed bowel was found, but a disruption of the abdominal wall musculature was clearly seen on the CT scan. If the disruption of abdominal wall muscles is unclear, local dilated intestinal loops might indicate intestinal obstruction or herniation into the abdominal wall.…”

“…In most reported cases, surgical repair was performed immediately. [1][2][3][4][5][6][7][8][9][10] We report a case of handlebar hernia managed conservatively with excellent results.…”

“…1,5,9 Only about 30 cases of handlebar hernia have been reported in the English literature. [1][2][3][4][5][6][7][8][9][10][11] More than 80% of TAWHs are caused by lower energy trauma as a result of bicycle-handlebar injuries. 9 It is noteworthy that this type of injury is infrequently associated with other organ injuries.…”

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

“…The use of mesh techniques is probably dependent on the size of the hernia and concomitant injury. Associated injuries are uncommon, but may be very serious [1][2][3][4].…”