Motorbike-handlebar hernia - a rare traumatic abdominal wall hernia: a case report and review of the literature

BACKGROUND: Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia without necessarily disrupting the overlying skin. Other than a reducible swelling on the abdominal wall, the physical examination of such patients is usually unremarkable and the diagnosis could easily be missed. CASE PRESENTATION: An 8-year-old Cameroonian boy with no significant past history presented to our emergency service with a tender left flank swelling following a road traffic accident. He was knocked down by a motorbike with resulting impact of the handlebar on his abdomen. A handlebar hernia was diagnosed on the basis of a reducible abdominal swelling with a positive cough impulse. A herniorrhaphy was done the following day after resuscitation and his postoperative period was uneventful. CONCLUSIONS: Handlebar hernias, although rare, should be suspected when patients present with an abdominal swelling following blunt abdominal trauma involving a handlebar-like object. A good history and physical examination are usually enough to pose an early diagnosis of handlebar hernia. Management typically involves surgical intervention to prevent complications. The timing and surgical approach should be decided on a case-by-case basis.