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Traumatic Abdominal Wall Hernia in Children by Handlebar Injury: When to Suspect, Scan, and Call the Surgeon

Victoria Elisa Rinaldi1, Mirko Bertozzi2, Elisa Magrini2

  • 1From the Departments of Paediatrics.

Pediatric Emergency Care
|April 26, 2017
PubMed

Insights

Traumatic abdominal wall hernias (TAWHs) are rare injuries in children following blunt trauma. Early detection is crucial due to potential internal injuries, often requiring surgical repair.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Abdominal Imaging

Background:

  • Traumatic abdominal wall hernias (TAWHs) result from blunt force trauma disrupting abdominal wall integrity.
  • TAWHs occur in about 1% of blunt abdominal trauma cases, with limited pediatric data.
  • The
  • handlebar sign
  • is associated with a higher risk of internal injuries.

Observation:

  • This study presents two pediatric cases of TAWH caused by bicycle handlebar impacts.
  • Clinical presentations of TAWH are variable, often necessitating advanced imaging like CT scans and ultrasounds for diagnosis.
  • Occult hernias, not apparent on initial examination, are frequently detected via imaging.

Findings:

  • Internal injuries accompany TAWHs in 25% to 70% of cases.
  • Surgical exploration and defect closure are the standard treatments for TAWH.
  • Variable clinical presentations and management strategies for pediatric TAWH were observed.

Implications:

  • Increased clinical suspicion and early detection of TAWH in pediatric blunt trauma are vital.
  • This work aims to equip clinicians with tools for identifying these insidious injuries.
  • Prompt diagnosis and management of TAWH can prevent complications and improve outcomes in pediatric patients.

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