WOFAPS 2025 8th World Congress of Pediatric Surgery

Maria Eugenia Ruiz Botero, Daniela Moreno, Juan Javier Valero-Halaby, Ivan Molina, Maria Romero, Paula Andrea Quintero

Universidad Nacional de Colombia, Fundación Hospital pediátrico La Misericordia

Purpose:
Describe the clinical characteristics and experience in treatment in pediatric patients with abdominal trauma due to bicycle handle from January 2010 to December 2024 at a pediatric reference hospital in Colombia.

Methods:
Retrospective case series, with information taken from the clinical records. Variables are presented in measures of central tendency and percentages.

Results:
We found 21 patients with abdominal trauma due to bicycle handle from 2010 to 2024. Ages at presentation were between 4 to 14 years old; 85% were male. Mean time to initial consultation was 75 hours. Tachycardia and handle tattoo in the abdominal wall were found at presentation in 57% each. Only 4 patients (19%) showed peritoneal irritation signs at presentation. Hemoglobin and liver workup were abnormal in 33% (7) and 23% (5) of the patients respectively. The most frequent image modalities to evaluate these patients were abdominal ultrasound (57%) and abdominal computed tomography (81%). Fourteen patients (66%) had an intraabdominal organ injury; Injured organs were bowel in 35.7% of cases, liver 28%, pancreas 21%, biliary tree 7.1% and omentum in 7.1%. From this, 64.2 % required surgical intervention. Laparotomy, laparoscopy and percutaneous procedures were performed in 42.8%, 28.5% and 7.1% of the cases respectively, with the most common finding being bowel injury. Of those with intraabdominal injury not requiring intervention, liver injury was the most common finding. Mean hospital stay and follow up were 9 days and 59 days respectively. No deaths are reported in our cohort due to the injuries.

Conclusions:
Abdominal trauma with bicycle handle can produce potentially life-threatening injuries in children. The most common injury in our patients was bowel perforation requiring resection and anastomosis. Recognition and early intervention (surgical or non-surgical) are fundamental for the good outcome of patients.