CT Findings of Pediatric Handlebar Injuries

Biyyam, Deepa R.; Hwang, Steven W.; Patel, Mittun C.; Bardo, Dianna M. E.; Bailey, Smita; Youssfi, Mostafa

doi:10.1148/rg.2020190126

Cited by 14 publications

(4 citation statements)

References 24 publications

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“…Those patients with a positive CT and seatbelt sign should be evaluated for operative or non-operative management. Similar injuries may be identified in paediatric populations from the impact of the handlebar of a bicycle, in such situations the same clinical suspicion should be applied [ 16 ].…”

Section: Blunt Abdominal Trauma: Observation and Nonoperative Managementmentioning

confidence: 99%

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

et al. 2022

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The aim of this paper was to review the recent literature to create recommendations for the day-to-day diagnosis and surgical management of small bowel and colon injuries. Where knowledge gaps were identified, expert consensus was pursued during the 8th International Congress of the World Society of Emergency Surgery Annual (September 2021, Edinburgh). This process also aimed to guide future research.

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Section: Blunt Abdominal Trauma: Observation and Nonoperative Managementmentioning

confidence: 99%

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

et al. 2022

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“…CT is the first-line investigation. It aids with pancreatic injury grading as well as assessment for other life-threatening injuries [ 6 ]. Direct and indirect signs of pancreatic duct injury on CT include complete gland transection, > 50% laceration through the gland, or the presence of early peripancreatic fluid [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Paediatric pancreatic trauma in North Queensland: a 10-year retrospective review

et al. 2023

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Purpose To establish the incidence of pancreatic trauma in North Queensland to the region’s only tertiary paediatric referral centre, and to determine the patient’s outcomes based on their management. Methods A single centre, retrospective cohort study of patients < 18 years with pancreatic trauma from 2009 to 2020 was performed. There were no exclusion criteria. Results Between 2009 and 2020 there were 145 intra-abdominal trauma cases, 37% from motor vehicle accidents (MVA), 18.6% motorbike or quadbike, and 12.4% bicycle or scooter accidents. There were 19 cases of pancreatic trauma (13%), all from blunt trauma and with associated injuries. There were 5 AAST grade I, 3 grade II, 3 grade III, 3 grade IV injuries, and 4 with traumatic pancreatitis. Twelve patients were managed conservatively, 2 were managed operatively for another reason, and 5 were managed operatively for the pancreatic injury. Only 1 patient with a high grade AAST injury was successfully managed non-operatively. Complications included pancreatic pseudocyst (n = 4/19; 3 post-op), pancreatitis (n = 2/19; 1 post op), and post-operative pancreatic fistula (POPF) (n = 1/19). Conclusion Due to North Queensland’s geography, diagnosis and management of traumatic pancreatic injury is often delayed. Pancreatic injuries requiring surgery are at high risk for complications, prolonged length of stay, and further interventions.

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“…Direct handlebar impact is most likely to cause injuries to the pancreas, small bowel, mesentery, liver, and spleen [ 1 ]. In the pediatric population, the relatively thin body wall may increase the risk of abdominal injury following the impact.…”

Section: Introductionmentioning

confidence: 99%

“…Traumatic gallbladder rupture comes with some serious complications, such as bile leak, infection, necrosis, and even hemobilia. Factors that are hypothesized to contribute to this rarity include the gallbladder’s protected anatomical location, decreasing number of children engaging in outdoor activities, and the smaller impact target offered by the gallbladder [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Handlebar Injuries: Not Always the Pancreas

Cacciatore,

Pellegrin,

Kashmer

et al. 2023

Cureus

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This case report highlights a rare traumatic gallbladder rupture secondary to a handlebar impact to the abdomen. Traumatic gallbladder rupture is only seen in 1.9-2.1% of all reported abdominal trauma. The diagnosis can be delayed due to the rarity of injury and the non-specific symptoms that a patient may present with. This case highlights the need for high clinical suspicion based on the mechanism of injury and imaging studies (focused assessment with sonography (FAST) and computed tomography (CT) scan) to direct treatment of concurrent injuries to assure the best outcome and prevent complications and morbidity. This patient was treated surgically with cholecystectomy and was discharged in stable condition.

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CT Findings of Pediatric Handlebar Injuries

Cited by 14 publications

References 24 publications

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

Paediatric pancreatic trauma in North Queensland: a 10-year retrospective review

Handlebar Injuries: Not Always the Pancreas

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