Bicycle handlebar injuries in children : findings on CT abdomen of 3 cases

Introduction Blunt abdominal injuries in children caused by bicycle handlebar are often difficult to diagnose, and the severity of the underlying injury may not be realized during the initial patient admission to the Emergency Department. High index of suspicion with proper radiologic evaluation can help identify presence of internal injuries. This will lead to appropriate and timely treatment. Case Series We report and illustrate 3 cases of blunt abdominal injuries resulting from trauma due to the bicycle handlebar in children. All patients had an imprint of the handlebar edge on their hypochondrium. One patient showed no signs of severe abdominal injury immediately after the trauma and were assessed as being fit to remain at home, but presented again 2 days later with abdominal pain and vomiting. The other 2 patients were admitted to the Emergency Department within 12 hours post trauma. All injuries were evaluated with ultrasound and computed tomographic (CT) scans. On ultrasound, intra abdominal free fluid was identified in 1 patient, while the other 2 patients showed no remarkable findings. However, further evaluation with CT scan revealed pancreatic transection in 2 patients and stomach perforation in 1 patient. The patients with pancreatic transection were treated conservatively while the patient with stomach perforation underwent surgery. Conclusion Children with suspected blunt abdominal injury caused by bicycle handlebar should be assessed and evaluated with great care. Thorough clinical assessment and appropriate radiological evaluation may help reduce morbidity from delay in diagnosis, which may hinder a timely management