Handlebar hernia in children.

Handlebar hernia is a rare form of traumatic abdominal wall hernia usually occurring in children. As the name suggests, it results from the blunt impact of a handlebar after a fall from a bicycle. A classic case is described of such a hernia occurring in a 14-year-old boy who presented with minimal external signs of injury, but was found to have significant traumatic disruption to the abdominal wall musculature and peritoneum, requiring surgical repair. A review of the English literature found only 25 cases of handlebar hernias in children less than 16 years of age. The average age is 9 years, and two-thirds of cases occur in boys. The frequency of associated visceral injury is low. The majority of reported cases were managed with surgical exploration and simple suture repair. Despite minimal signs on examination, the history should raise suspicion of significant underlying muscular disruption.