Bicycle handlebar injuries of pancreas in children

Abstract

Handlebar injuries are one of the most common causes of abdominal injuries in children. Early diagnosis and optimal care without delay may help to reduce the morbidity of injuries to the internal organs. Children with abdominal handlebar injuries should be treated with great care. We describe a young girl presented after a bicycle accident having received a sharp blow from her handlebars to just below her left costal margin. She was admitted for observation and for her primary investigation. After becoming peritonitic, her pancreatic amylase and lipase increased to 3,57 μkat/l and 16,37. Axial CT scan showed transection of the pancreas. An endoscopic retrograde cholangio-pancreatography (ERCP) confirming ductal transection. In quest of bridging the pancreatic duct and securing drainage of pancreatic juice, a pancreatic stent was placed preoperatively. Due to complete transection of the pancreas body with simultaneous interruption of the pancreatic duct, distal pancreatectomy was performed with the spleen saving. The patient recovered well and 12 weeks later, after the stent was removed, there was no evidence of pancreatic stricture.