Bicycle-handlebar Hernia: A Rare Traumatic Abdominal Wall Hernia

Chen, Hsien-Ying; Sheu, Ming-Huei; Tseng, Li-Ming

doi:10.1016/s1726-4901(09)70152-2

Cited by 25 publications

(26 citation statements)

References 11 publications

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“…Not surprisingly, more cases of TAWH have been reported in children owing to the thin parietal wall and more elastic skin. 2 The first case of TAWH was reported by Selby in 1906. 3 Strict criteria for diagnosis were first laid down by McWhorter, later modified by Clain and Damschen et al; these included immediate appearance of the swelling following blunt trauma and failure of the injury to penetrate the skin.…”

Section: Discussionmentioning

confidence: 99%

“…1 The most common cause appears to be bicycle handlebar injury, especially in children. 2 High velocity injuries are sustained during road traffic accidents. The pathophysiology leading to hernia development is believed to be the result of a tangential shearing force on the musculoaponeurotic layers associated with a sudden increase in intra-abdominal pressure, as occurs when performing the Valsalva manoeuvre.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic abdominal wall hernia with concealed colonic perforation

Pathak

Mukherjee

Das

et al. 2016

annals

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Traumatic abdominal wall hernia (TAWH) is a rare clinical entity in terms of aetiology. It occurs following a blunt abdominal injury with energy high enough to cause disruption of the musculoaponeurotic layer but not the elastic skin layer. It is often associated with underlying intra-abdominal injuries, which can be diagnosed either clinically or radiologically. We report a case of TAWH in a young man with associated large bowel transection, which remained undiagnosed in the preoperative period owing to its masked features. He was managed surgically, with no recurrence to date. Considering the high volume of blunt abdominal trauma cases that present to the accident and emergency department, only few cases of TAWH have been reported in the literature. Confusion still exists regarding the timing and mode of management of this condition. KEYWORDSAbdominal wall -Traffic accidents -Abdominal hernia -Aetiology -Motorcycles Traumatic abdominal wall hernia (TAWH) is an unusual type of hernia that occurs following a non-penetrating abdominal trauma resulting in breach of the musculoaponeurotic layers of the abdomen with an intact overlying skin. Although blunt abdominal trauma is very common, the incidence of TAWH is low. The diagnosis of TAWH is rarely straightforward owing to the various clinical presentations and management therefore varies substantially. 1 We report a unique case of TAWH following a road traffic accident with associated hollow viscous injury. Case historyA 30-year-old man presented to the accident and emergency department having sustained a high velocity blunt trauma injury over his left flank from a hollow metal pipe two hours earlier while driving a motorcycle. The patient was haemodynamically unstable. He had a tender, irreducible swelling of approximately 15cm x 10cm over the left flank with evidence of an overlying bruise and abrasions (Fig 1). There was no expansile cough impulse over the swelling and the swelling was soft in consistency. General abdominal examination was insignificant and there was no peritonitis. Focused assessment with sonography for trauma showed no intra-abdominal fluid collection. However, ultrasonography indicated a possible parietal breach at the site of the lump. Multidetector computed tomography (CT) of the abdomen revealed a full-thickness defect over the left lumbar region with small bowel herniation (Fig 2).The patient was posted for an exploratory laparotomy by a midline approach. A 20cm loop of jejunum was found to be herniating through a gap of 7cm over the left lumbar region. A complete transection of the descending colon was also noted (Fig 3). Both the proximal and distal ends of the transected colon were also seen to be herniating through the defect. There was collection of stool and blood clots in the ONLINE CASE REPORT Ann R Coll Surg Engl 2016; 98: e133-e135

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic abdominal wall hernia with concealed colonic perforation

Pathak

Mukherjee

Das

et al. 2016

annals

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“…Handlebar hernias, which are localized defects, are even more infrequent, only 28 cases reported since 1939 [1]. It involves disruption of the abdominal wall muscles, with bowel loop herniated through the defect in the abdominal wall.…”

Section: Case Reportmentioning

confidence: 99%

“…The first reported case was in 1906. Few cases were reported in the literature [1]. Handlebar hernias, which are localized defects, are even more infrequent.…”

Section: Introductionmentioning

confidence: 99%

Traumatic handlebar hernia: case report of rare type of abdominal wall hernia

Baderalmaarif¹,

Nugud²,

Alawad³

2015

Glob Surg

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Matsuo¹,

Okada²,

Murakami³

2007

Surg Today

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Handlebar hernia is a rare type of blunt traumatic abdominal wall hernia (TAWH). It involves a disruption of the abdominal wall muscles, with bowel loop herniation through the defect in the abdominal wall. We report a case of bicycle-handlebar hernia in a 9-year-old boy who had all layers of his abdominal wall disrupted after falling from his bicycle. He was brought to our hospital with lower abdominal pain and bulging. A physical examination revealed left lower quadrant bulging in a standing posture, and a palpable fascial defect, 3 cm in diameter. Computed tomography showed a disruption of the abdominal rectal muscle layer, but his skin and intra-abdominal organs were completely intact. The patient was treated conservatively with abdominal wall compression using a cotton cloth corset. Within 3 weeks, his abdominal wall hernia had healed without the need for any surgical intervention.

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Bicycle-handlebar Hernia: A Rare Traumatic Abdominal Wall Hernia

Cited by 25 publications

References 11 publications

Traumatic abdominal wall hernia with concealed colonic perforation

Traumatic abdominal wall hernia with concealed colonic perforation

Traumatic handlebar hernia: case report of rare type of abdominal wall hernia

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

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