Abstract

Background:Pediatric traumas are routinely categorized into blunt and penetrating types. Bicycle handlebar exerts a biphasic or dual effect (it is primarily a blunt mechanism but due to its focused effect, it disrupts the muscles without cutting the skin). In 1964, Roberts reported a 9-year-old boy with acquired abdominal wall hernia after a fall upon a bicycle handlebar to be the second case of traumatic abdominal wall hernia after Landry report in 1956. Since then, more than 66 pediatric cases have been reported. In dealing with cases having this type of injury, radiologic studies are warranted to reveal the injured parieties and organs, address these injuries, and achieve optimum case stabilization. Here in this article, we present our experience in management of pediatric traumatic abdominal wall hernia case and literature review.

Case Presentation: An 11-years-old boy presented to the ER of Al-Houssain university hospital with traumatic ventral hypogastric hernia caused by bicycle handlebar impact to his lower abdomen. The case was initially assessed, stabilized, managed operatively and followed until improved and became ready for discharge.

Conclusion: Traumatic abdominal wall hernias occurs in response to concentrated impact by handlebar to the abdomen leading to muscle yielding but the resilient elastic nature of the skin keeps it intact. These injuries should be suspected in the setting of suggestive trauma mechanism followed by abdominal swelling and should be dealt with timely and seriously on an individual basis to restore the disrupted anatomy.

Keywords: Traumatic Hernia; Bicycle Handlebar Injury; Ventral Hernia; Blunt Abdominal Trauma; Exploratory Laparotomy; Conservative Management

References

1. Killeen KL., et al. “Using CT to diagnose traumatic lumbar hernia”. American Journal of Roentgenology 5 (2000): 1413-1415.
2. Dimyan W., et al. “Handlebar hernia”. Journal of Trauma 9 (1980): 812-813.
3. “Intra-abdominal injury with handlebar hernia: case report and literature review”. Journal of Trauma 40.1 (1996): 116-118.
4. Kubalak G. “Handlebar hernia: case report and review of literature”. Journal of Trauma 36 (1994): 438-439.
5. Jones BV., et al. “Traumatic abdominal wall hernia”. American Journal of Emergency Medicine 6 (1989): 667-668.
6. Angelo Mikrogianakis. “Penetrating Abdominal Trauma in Children”. Clinical Pediatric Emergency Medicine 11 (2010): 217-224.
7. Damschen DD., et al. “Acute traumatic abdominal hernia: case reports”. Journal of Trauma 2 (1994): 273-276.
8. Jahromi AH., et al. “What we know about management of traumatic abdominal wall hernia: review of the literature and case report”. International Surgery 100 (2015): 233-239.
9. Singal R., et al. “Traumatic anterior abdominal wall hernia: a report of three rare cases”. Journal of Emergencies, Trauma, and Shock 1 (2011): 142-145.
10. Lane CT., et al. “Management of traumatic abdominal wall hernia”. The American Surgeon 1 (2003): 73-76.
11. Wood RJ., et al. “Traumatic abdominal hernia: a case report and review of the literature”. The American Surgeon 11 (1988): 648-651.
12. Shiomi H., et al. “Handlebar hernia with intra-abdominal extra-luminal air presenting as novel form of traumatic abdominal wall hernia: report of a case”. Journal of Surgery 12 (1999): 1280-1284.
13. Goliath J., et al. “Traumatic handlebar hernia: a rare abdominal wall hernia”. Journal of Pediatric Surgery 10 (2004): e20-e22.
14. Hassan KA., et al. “Handlebar hernia: a rare type of abdominal wall hernia”. Saudi Journal of Gastroenterology 1 (2008): 33-35.
15. Upasani A and Bouhadiba N. “Paediatric abdominal wall hernia following handlebar injury: should we diagnose more and operate less?” BMJ Case Reports 19 (2013): bcr2012008501.
16. Mancel B and Aslam A. “Traumatic abdominal wall hernia: An unusual bicycle handlebar injury”. Pediatric Surgery International 19 (2003): 746-747.
17. Ankit Shukla., et al. “Handlebar hernia with triple herniation and perforation: a case report and literature review”. Bulletin of Emergency and Trauma 3 (2018): 257-261.
18. Dreyfuss DC., et al. “Acute trans-rectus traumatic hernia”. Journal of Trauma 12 (1986): 1134-1136.
19. Cheng S-P., et al. “Handlebar hernia: a misleading term”. Injury Extra8 (2005): 309-311.
20. Mitchiner JC. “Handlebar hernia: diagnosis by abdominal computed tomography”. Annals of Emergency Medicine 7 (1990): 812-813.
21. Van Bemmel AJ., et al. “Handlebar hernia: a case report and literature review on traumatic abdominal wall hernia in children”. Hernia4 (2011): 439-442.
22. Gupta S., et al. “Traumatic abdominal wall hernia”. Ulusal Travma Ve Acil Cerrahi Dergisi 17 (2011): 493-496.
23. Losanoff JE., et al. “Handlebar hernia: ultrasonography aided diagnosis”. Hernia1 (2002): 36-38.
24. Herbert RJ., et al. “Traumatic abdominal wall hernia in a 7-year-old child”. Journal of Pediatric Surgery 8 (1973): 975-978.
25. Kubota A., et al. “Handlebar hernia: case report and review of pediatric cases”. Pediatric Surgery International 5-6 (1999): 411-412.
26. Ludmila Haimovici., et al. “Handlebar hernia: traumatic abdominal wall hernia with multiple enterotomies. A case report and review of the literature”. Journal of Pediatric Surgery 42 (2007): 567-569.
27. Prada AM., et al. “Handlebar hernia: traumatic abdominal wall hernia with multiple enterotomas”. European Journal of Pediatric Surgery 14 (2004): 133-136.
28. Agarwal N., et al. “Traumatic abdominal wall hernia in two adults: a case series”. Journal of Medical Case Reports 3 (2009): 7324.
29. Lutz N., et al. “Incidence and clinical significance of abdominal wall bruising in restrained children involved in motor vehicle crashes”. Journal of Pediatric Surgery 39 (2004): 972-975.
30. Paris C., et al. “Predictive indicators for bowel injury in pediatric patients who present with a positive seat belt sign after motor vehicle collision”. Journal of Pediatric Surgery 45 (2010): 921-924.
31. Della Porta M., et al. “Traumatic hernia of the abdominal wall: a case report”. Chirurgia Italiana 1 (2008): 131-133.
32. Goh SC., et al. “Traumatic bicycle handlebar hernia”. European Journal of Emergency Medicine 3 (2008): 179-180.
33. Holmes JH., et al. “Thoracic handlebar hernia: presentation and management”. Journal of Trauma 1 (2002): 165-166.
34. Litton K., et al. “Management of a traumatic abdominal wall hernia after a bicycle handlebar injury (case report and literature review) ”. Journal of Pediatric Surgery 4 (2008): e31-e32.
35. Volpe A., et al. “Successful conservative management of handlebar hernia in children”. Pediatrics International 59 (2017): 105-106.
36. Theodorou CM., et al. “Traumatic posterolateral abdominal wall hernia in a pediatric patient”. Journal of Pediatric Surgery Case Reports 43 (2019): 23-25.

Citation

Citation: Muhammad Elsayed Abdelhafez Mahmoud. “Traumatic Ventral Hypogastric Hernia: A Case Report and Review of Literature in Pediatrics” Acta Scientific Paediatrics 3.4 (2020): 43-50.

Copyright

Copyright: © 2020 Muhammad Elsayed Abdelhafez Mahmoud. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.