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Intra-abdominal Injury in Handlebar Hernia

Arch Surg. 1986;121(4):491-492. doi:10.1001/archsurg.1986.01400040129023.
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To the Editor.—"Handlebar" hernias are an uncommon form of traumatic abdominal wall hernia first reported by McWhorter1 in 1939. A total of nine cases have been reported. Curiously, to my knowledge, no previously reported case of handlebar hernia has been associated with a significant intra-abdominal injury.2 The following case report documents such an association.

Report of a Case.—A 40-year-old male motorcyclist was examined shortly after colliding with an automobile. The patient was struck in the right lower quadrant of the abdomen by the motorcycle handlebar. The patient complained only of abdominal pain and had stable, normal vital signs. Notable findings were limited to a 7 × 5-cm, fluctuant swelling in the right lower quadrant. An underlying musculofascial defect was palpable, measuring 6 × 4 cm, with a reducible herniation of abdominal viscera. Generalized abdominal muscular guarding and rebound tenderness were evident, and bowel sounds were absent.


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