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Vital signs were as follows: blood pressure 121/64 mmHg, beats per minute 80/min, and body temperature 36.5☌. He presented with epigastric and right hypochondrium abdominal pain after injured the handlebar of the bicycle, with nausea and hematemesis. The early diagnosis is important to reduce the morbidity and mortality.Ī 17-year-old male presented to the emergency room after an accidental fall with his bicycle. They rarely present as single lesions as other visceral lesions are usually associated. Duodenal injury is very rare, produced by high-energy trauma. The postoperative period was uneventful and the patient was discharged after 16 days of stay. A resection of the perforated third-part duodenal rupture was performed, and the transit was reconstructed using a Roux-Y duodenojejunostomy. A contrast abdominal computed tomography was performed and he was diagnosed with third-part duodenal rupture. He presented with hematemesis without hemodynamic repercussion. On physical examination, there was a swelling in the upper right abdominal quadrant and epigastrium with tenderness on deep palpation.
![handlebar sign trauma handlebar sign trauma](https://i.ytimg.com/vi/Omsava2CTgk/hqdefault.jpg)
We present the case of a 17-year-old patient seen in the emergency room after falling off his bicycle and presented a blunt trauma in the epigastric region. The diagnosis of duodenal injuries after trauma is difficult and requires a high index of clinical suspicion. Bicycle accidents continue to lead to morbidity and mortality in children, representing between 5% and 14% of total blunt abdominal injuries. It is up to five times more frequent in males, with an average age between 16 and 30 years. Duodenal lesions after abdominal trauma in children are infrequent and tend to be secondary to traffic accidents. Unstable patients or those with suspicion of hollow viscera perforation will require surgery as first approach.Blunt abdominal trauma is most frequent in the pediatric population. Non-surgical ma nagement is becoming more used for stable patients, achieving high success rates. A CT scan showed a he patic injury that was managed with non-surgical procedures, achieving resolution of the lesion after 8 weeks of follow-up.īlunt abdominal trauma caused by handlebar can be potentially serious in pediatric patients, since it may affect solid and hollow abdominal viscera.
![handlebar sign trauma handlebar sign trauma](https://sobolaw.com/wp-content/uploads/2023/02/types-of-traumatic-brain-injuries-scaled.jpg)
3) 9-year-old boy admitted due to a hit with the bicycle handlebar on the abdomen area. After 6 weeks of follow-up, he presented resolution of the lesion and viability of the spleen. A CT scan showed a splenic injury with multiple lacerations and active bleeding that was treated with angioembolization. 2) 14-year-old boy seen at ED after a bicycle accident in which the handlebar hit him in the abdomen area. A la parotomy was performed and the duodenal perforation repaired. A CT scan showed signs of duodenal perforation.
![handlebar sign trauma handlebar sign trauma](http://img.medscapestatic.com/pi/meds/ckb/77/36377tn.jpg)
The aim of this study is to describe three cases of blunt abdominal trauma due to handlebar injury in children, in order to illustrate the different kinds of lesions, their presentation, and management.ġ) 11-year-old boy presented to Emergency Department (ED) after falling on a bi cycle handlebar, hitting his epigastric region. In Chile, there are no scientific articles about such accidents, their presentation and management. Bicycle accidents are a frequent cause of blunt abdominal trauma in children.