2008, Number 6
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Cir Cir 2008; 76 (6)
Vestigio clínico inusual asociado a abdomen agudo traumático
Baeza-Herrera C, Atzín-Fuentes JL, Ramírez-Meneses ME, González-Mateos T, López-Castellanos J
Language: Spanish
References: 26
Page: 481-485
PDF size: 67.53 Kb.
ABSTRACT
Background: Bicycling is popular among children; 80 to 90% of school-age children own bicycles. Unfortunately, bicycle crashes result in ~600 deaths each year in the U.S. Additionally, direct impact handlebar injuries to the liver, spleen, pancreas, duodenum, intestine, kidneys, urethra and major vessels have all been reported. The purpose of our study was to outline the mechanism of serious bicycle handlebar-related injuries and emphasize the role of abdominal abrasion as a sign of acute abdomen.
Methods: Medical records for patients discharged for contusion of the skin with and without visceral lesion due to handlebar injury were compared with 112 bicycle falls.
Results: Six patients had abdominal contusion with imprints and visceral lesion and another six patients had contusion without any imprints or visceral lesion. Stastistical anlysis showed
p ‹0.0001.
Conclusions: Abdominal handlebar injuries associated with abdominal imprints demonstrated peritonitis risk.
REFERENCES
Wotherspoon S, Chu K, Brown AFT. Adominal injury and the seat belt sign. Emerg Med 2001;13:61-65.
Tepas JJ, Ramenofsky ML. The pediatric trauma score as a predictor of injury severity: an objective assessment. J Trauma 1988;28:425-430.
Baeza CH, Godoy EHE, García LMC, Herrera PVA. Traumatic asphyxia in children. Bol Med Hosp Infant Mex 1997;54:379-382.
Hu X, Wesson DE, Chipman ML, Parkin PC. Bicycling exposure and severe injuries in school-age children. Arch Pediatr Adolesc Med 1995;149:437-441.
Spence LJ, Dykes EH, Bohn DJ, Wesson DE. Fatal bicycle accidents in children: a plea for prevention. J Pediatr Surg 1993;28:214-216.
Rohatgi M, Gupta DK. Isolated complete transection of common bile duct following blunt bicycle handlebar injury. J Pediatr Surg 1987;22:1029-1030.
Fraser GC. “Handlebar” injury of the pancreas. Report a case complicated by pseudocyst formation with spontaneous internal rupture. J Pediatr Surg 1969;4:216-219.
Guarino J, Hassett MJ, Luchette FA. Small bowel injuries: mechanisms, patterns, and outcome. J Trauma 1995;39:1078-1080.
Taylor GA, Fallat ME, Potter BM, Eichelberger RM. The role of computed tomography in blunt abdominal trauma in children. J Pediatr Surg 1988;28:1660-1664.
Chatterjee H, Jagdish S. Intestinal injuries in childhood. Analysis of 32 cases. J Pediatr Surg 1992;27:583-585.
Baeza CH, García CLM, González ZEF, Osorio CDA. Perforación duodenoyeyunal por percance en bicicleta. Bol Med Hosp Infant Mex 2000;57:390-395.
Clendenon JN, Meyers RL, Nance ML, Scaife ER. Management of duodenal injuries in children. J Pediatr Surg 2004;39:964-968.
Karjoo M, Domachowske J, Turst S. Intramural hematoma of the descending colon after blunt abdominal trauma. Clin Pediatr 2000;39:373-374.
Läckgren G, Lörelius LE, Olsen L, Wassen C. Hemobilia in childhood. J Pediatr Surg 1988;23:105-108.
Dreyfus CD, Flancbaum L, Jrasna HI, Tell B, Trooskin SZ. Acute transrectus traumatic hernia. J Trauma 1986;26:1134-1136.
Tracy TF, Silen ML, Graham MA. Delayed rupture of the abdominal aorta in a child after a suspected handlebar injury. J Trauma 1996;40:119-120.
Kubalak G. Handlebar hernia; Case report and review of the literature. J Trauma 1994;36:438-439.
Sparnon T, Moretti K, Sach RP. BMX handlebar. To threat to manhood? Med J Austral 1982;2:587-588.
Acton HCC, Clark TS, Pitt WR, Nixon JW, Leditschke JF. Bicycle incidents in children-abdominal trauma and handlebars. Med J Austr 1994;160:344-345.
Tuck JS. Letter. Br Med J 1984;289:1227.
Sparnon A. BMX bike injuries. Br Med J 1984;289:1226-1227.
Nadler EP, Patoka DA, Shultz BL, Morrison KE, Ford HR. The high mortality associated with handlebar injuries. J Trauma 2005;58:1171-1174.
Winston FK, Shaw KN, Kreshak AA, Schwarz DF, Gallagher PR, Cnaan A. Hidden spears: handlebar as injury hazards to children. Pediatrics 1998;102:596-601.
Arbogast KB, Cohen J, Otoya J, Winsnton FK. Protecting the child´s abdomen: a retractable bicycle handlebar. Accid Anal Prev 2001;33:753-757.
Lutz N, Nance ML, Kallan MJ, Arbogast KB. Incidence and clinical significance of abdominal wall bruising in restrained children involved in motor vehicle crashes. J Pediatr Surg 2004;39:972-975.
Spitz JD. Unrecognized fatal liver injury caused by a bicycle handlebar. Am J Emerg Med 1999;17:244-245.