Dhakre Vijay Waman, Kadam Sarvesh B, Gowda Akhilesh, Iyer Sandhya
Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
BMJ Case Rep. 2019 Nov 7;12(11):e231835. doi: 10.1136/bcr-2019-231835.
A 14-year-old boy presented with a painful swelling topped by a bruise overlying the skin of the right inguinal region without peritonitis. This was the area of impact of bicycle handlebar while riding 6 days ago. On contrast-enhanced CT scan, we found a traumatic abdominal wall hernia (handlebar hernia) near the right deep ring without any solid organ, bowel or urinary bladder injury. Inguinal exploration revealed a defect in transversus abdominis and internal oblique muscle which was repaired and meshplasty was done.Delayed presentation and ignorance towards 'handlebar sign' is associated with visceral injury (haematoma/perforation) will incur the risk of rising morbidity and mortality. With CT scan we can assess the abdominal cavity to rule out associated visceral or vascular injury. Surgical repair for restoring disrupted anatomy with or without meshplasty is the preferred approach.
一名14岁男孩因右腹股沟区皮肤有瘀斑覆盖的疼痛性肿胀就诊，无腹膜炎表现。该区域是6天前骑自行车时自行车车把撞击的部位。在增强CT扫描中，我们发现右深环附近有一个创伤性腹壁疝（车把疝），没有任何实质性器官、肠管或膀胱损伤。腹股沟探查发现腹横肌和腹内斜肌有缺损，进行了修补并实施了补片成形术。对“车把征”的延迟就诊和忽视与内脏损伤（血肿/穿孔）相关，会增加发病率和死亡率风险。通过CT扫描我们可以评估腹腔以排除相关的内脏或血管损伤。采用或不采用补片成形术进行手术修复以恢复解剖结构紊乱是首选方法。
