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Bicycle handlebar hernia with multiple enterotomies: a case report.

A F Tonsi¹, M Alkusheh, K Reddy

¹Department of Surgery, East Surrey Hospital, Redhill, Surrey RH1 5RH, England. alfredo@doctors.net.uk

Acta Chirurgica Belgica

|June 3, 2010

Summary

Bicycle handlebar hernias are rare traumatic abdominal wall hernias. A case report details a 14-year-old treated successfully for a small bowel injury secondary to this injury.

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Area of Science:

Trauma surgery
Abdominal wall reconstruction
Pediatric surgery

Background:

Bicycle handlebar hernias (BHH) are uncommon traumatic abdominal wall hernias (TAWH).
They result from direct blunt trauma to the anterior abdominal wall, often from low-impact incidents.
This case highlights a BHH in a young male without prior hernia history.

Observation:

A 14-year-old boy presented with a tender right iliac fossa lump after a bicycle fall.
Contrast-enhanced CT revealed intestinal loops protruding through an abdominal wall defect with pneumoperitoneum.
Findings suggested hollow viscus perforation, necessitating urgent surgical intervention.

Findings:

Emergency laparotomy identified a mesenteric tear and multiple enterotomies in the mid jejunum.
Surgical management included small bowel resection, mesenteric tear repair, and primary abdominal wall hernia repair.
The patient experienced an uncomplicated postoperative recovery.

Implications:

BHH can be associated with significant intra-abdominal injuries, including bowel perforation.
Exploratory laparotomy via a transverse skin crease incision facilitates thorough intra-abdominal assessment.
Primary repair of the abdominal wall defect is feasible and effective in managing BHH.