A rare case of abdominal trauma, a handlebar hernia, is described, as well as a review of the pertinent literature. A 7-year-old boy presented to our emergency room after sustaining blunt force to the abdomen; he fell on the handlebar of his bicycle. Immediately after the accident, a bulge was noticeable at the point of impact. Handlebar hernia is a diagnosis that is easily missed, which can lead to strangulation and incarceration of the bowel. With this case report, we hope to augment the knowledge on traumatic abdominal wall hernia, hopefully leading to early diagnosis and treatment.
The median age was 54 years (range 2-85 years), with a 3:2 female to male ratio. The median size of the tumours was 4.1 cm (range 2-12 cm) and metastases occurred in seven of the 25 cases. If any form of adjuvant therapy is used it is usually radiotherapy. Chemotherapy seems to be reserved for cases where metastasis occurs. Average survival was 4 years (range 1 month to 17 years). Currently the best treatment seems to be wide excision of the tumour, with selective vascular reconstruction combined with adjuvant radiotherapy.
Panaritium tendineum is a severe infection of the hand in most cases caused by infection with staphylococcal or streptococcal species. In this article, a case of panaritium tendineum caused by Haemophilus influenzae is described. In the literature, no cases of H. influenzae causing a panaritium tendineum are described before. The patient in this case was treated by repeated surgical incision and drainage, local antiseptic treatment, intravenous antibiotics, and 2 months of physiotherapy after which there remained some loss of function of the left hand.
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