Isolated Jejunal Perforation Following Bicycle Handlebar Injury in Adults: A Case Report

The small intestine is the third in frequency intraperitoneal organ which is injured after blunt trauma of the abdomen. In most of the cases, this type of injuries is accompanied by other injuries, which make it more difficult to diagnose. Failure of diagnosis and delay in treating these injuries significantly increase the morbidity and mortality of these patients. Abdominal visceral injuries after flipping the handlebar of the bike are common in children. Such injuries can cause injury to both solid and hollow abdominal viscera. Unlike children, adults’ abdominal visceral injuries after flipping the bike’s handlebar are extremely rare. A 25-year-old man was admitted to our department due to progressively abdominal pain after an accident with the handlebar of his bike. The subsequent CT scan after per os administration of contrast medium revealed the presence of free intraperitoneal contrast. It is a rare case of jejunal perforation after flipping the handlebar of the bicycle which was treated by partial removal of the injured part of jejunum and end-to-end anastomosis. To the best of our knowledge this is the first time we describe such an injury with this mechanism to an adult. 1. Introduction Intra abdominal organ injuries caused by a stroke of bike handlebars are well documented in children. Flipping the bicycle’s handlebars in the abdomen is common in children and can cause a variety of injuries such as traumatic rupture of solid organ (liver, spleen, pancreas, and kidney), rupture of hollow organs (intestine, stomach), posttraumatic hernias of the abdominal wall, and even injuries of intra-abdominal vessels (ruptured abdominal aorta, traumatic arterial occlusion) [1–7]. Apart from significant morbidity in children, these injuries are combined with a huge financial cost to health systems and beyond [8]. The abdomen is the third most common anatomical area of the body which undergoes blunt injuries, and 75% of these injuries are due to road-traffic accidents [9]. Although the lesions of the small intestine follow the frequency of liver and spleen injuries after blunt abdominal trauma, such frequency is small and limited to less than 5% of total injury [10]. The injuries are in most cases accompanied by other ones, which increases both the mortality of the patients and the difficulty in dealing with them [11]. Isolated lesions of the jejunum secondary to blunt trauma of the abdomen are very rare injuries, and few reports exist in the literature in the form of case reports [12–14]. Injuries from the bicycle’s handlebar are very rare in adults, and an