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Year : 2012  |  Volume : 2  |  Issue : 1  |  Page : 42-44

Handlebar hernia: A case report and review of literature

Department of Surgery, Division of General Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Correspondence Address:
Khalid Lawal
Department of Surgery, Division of General Surgery, Ahmadu Bello University Teaching Hospital, Zaria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9596.101275

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Introduction: Handlebar hernia is a specific type of traumatic abdominal wall hernia that is caused by impact of the abdominal wall against a blunt object, usually bicycle handlebars. The rarity of handlebar hernia and its frequent presentation without physical signs makes it highly susceptible to misdiagnosis which may be attended with serious consequences. We discuss the presentation and management of a case of handlebar hernia and a review of literature. Case Report: A 14-year-old boy presented to emergency department with pain at right inguinal area where the abdomen had impacted on the handlebar of the bicycle. Immediately after the accident, he noticed a swelling at the site of impact. He had no history of inguinal hernia. His examination revealed normal vital signs. There was abrasion in the right inguinal region and a reducible swelling with positive cough impulse. Abdominal ultrasound showed normal abdominal viscera and the swelling was noted to contain loop of bowel. A diagnosis of handlebar hernia was made. Through an incision over the bulge, a 10 cm loop of normal bowel found in the subcutaneous plane was reduced and the 5-cm defect in the anterior abdominal wall muscles repaired in layers. The boy remains well at 2½ years of follow-up. Conclusion: Handlebar hernia can be diagnosed based on history of mechanism of injury, careful physical examination, and high index of suspicion. Abdominal ultrasound or computed tomography is an important adjunct of management. Prompt surgical repair of the hernia is recommended to prevent incarceration or strangulation.

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