Analysis of the use of upright abdominal radiography for evaluating intestinal perforations in handlebar traumas: Three case reports.

RATIONALE

Intestinal perforations due to blunt abdominal handlebar trauma are difficult to diagnose. This report presents a retrospective analysis of 3 patients with intestinal perforations due to abdominal bicycle handlebar trauma who were diagnosed via upright abdominal radiography.

PATIENTS CONCERNS

All the patients lost their balance while riding a bicycle for leisure and had fallen on the handlebar tip. The patients were initially misdiagnosed at different-level health centers despite various radiologic investigations performed.

DIAGNOSIS

The patients' intestinal perforations were diagnosed via plain upright abdominal X-ray radiography (UAXR) in our institution.

INTERVENTIONS AND OUTCOMES

The children underwent exploratory laparotomy due to intestinal perforations. All the perforations were repaired either with primary closure or bowel resection and anastomosis with successful outcomes.

LESSONS

Pneumoperitoneum due to intestinal perforation can be diagnosed via UAXR with appropriate patient positioning and timing. This case series shows that to accurately diagnose intestinal perforations, upright plain X-ray should be routinely performed, carefully evaluated, and repeated in patients with enduring abdominal complaints.