title: Severe abdominal trauma involving bicycle handlebars in children.
abstract: OBJECTIVE
  To emphasize the severity of the underlying injury which may not be realized during the initial patient admission to the emergency department.
  
  
  METHODS
  A retrospective case note review of children admitted to our institution with the severe abdominal injury.
  
  
  RESULTS
  Eight children were identified with the severe abdominal injury secondary to the trauma from a bicycle handlebar that needed special care in the intensive care unit. All injuries were due to blunt trauma. The mean delay from the time of the accident to the time of presentation was 34.5 hours. All patients had an imprint of the handlebar edge on the hypochondrium. There were 3 pancreatic lacerations, 1 duodenal laceration, 1 jejunal laceration, 1 liver laceration, 1 abdominoinguinal laceration that all required open surgery, and 1 duodenal hematoma that resolved in 4 weeks follow-up period. The patients who required open surgery were evaluated with computed tomographic scans before surgery.
  
  
  CONCLUSIONS
  Children with an imprint made by the handlebar edge on the abdominal wall or give a clear history of injuries by a bicycle handlebar should be treated with great care. Early computed tomography evaluation may help to reduce the morbidity resulting from the delay in diagnosis of injuries to the internal organs.
authors.affiliation: Department of Pediatric Surgery, Cukurova University Faculty of Medicine, Adana, Turkey. drmuratalkan@hotmail.com
authors.forename: Murat
authors.initials: M
authors.lastname: Alkan
authors.forename: Serdar H
authors.initials: SH
authors.lastname: Iskit
authors.forename: Sureyya
authors.initials: S
authors.lastname: Soyupak
authors.forename: Recep
authors.initials: R
authors.lastname: Tuncer
authors.forename: Hasan
authors.initials: H
authors.lastname: Okur
authors.forename: Erbug
authors.initials: E
authors.lastname: Keskin
authors.forename: Unal
authors.initials: U
authors.lastname: Zorludemir
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D001642:Bicycling / Q000293:injuries*; D002648:Child; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007813:Laparotomy; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D014421:Turkey / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery