Citation

England RJ, Dalton R, Walker J. Inj. Extra 2004; 35(4): 40-41.

Copyright

(Copyright © 2004, Elsevier Publishing)

DOI

10.1016/j.injury.2004.01.022

PMID

unavailable

Abstract

A 13-year-old, fit and healthy boy, was brought by paramedic ambulance to the Accident and Emergency, (A and E) Department, after falling off his bicycle. He had been riding alongside a friend, both going down hill and, on attempting to turn left, had got his T-shirt caught in the handlebars of his friends bicycle. The patient fell directly onto the brake lever attached to the handlebars, sustaining a penetrating injury to the abdominal wall. The bicycle was not reported to be damaged. There have been many reports of abdominal injury in children caused by bicycle handlebars. The vast majority of these are blunt injuries, with the liver and spleen being the most commonly injured solid organs. Injuries to the kidneys, duodenum, small bowel (including perforation), and pancreas have also been described, as have vascular injuries such as damage to the intima of the common femoral artery and external iliac artery. Blunt handlebar trauma to the abdomen is associated with severe, sometimes life-threatening, intra-abdominal injuries, often requiring surgery and sometimes resulting in prolonged hospital admissions. Penetrating injuries to the abdomen following bicycle accidents are, however, rare in the literature, as are reports of abdominal evisceration. There has been concern over the design of bicycle handlebars for some years now, [see also: P.J. McKenna, D.J. Welsh and L.W. Martin, Paediatric bicycle trauma. J Trauma 31 3 (1991), pp. 392].