{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:54:40Z","timestamp":1782867280844,"version":"3.54.5"},"reference-count":10,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,10]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>A 14-year-old boy presented with a painful swelling topped by a bruise overlying the skin of the right inguinal region without peritonitis. This was the area of impact of bicycle handlebar while riding 6 days ago. On contrast-enhanced CT scan, we found a traumatic abdominal wall hernia (handlebar hernia) near the right deep ring without any solid organ, bowel or urinary bladder injury. Inguinal exploration revealed a defect in transversus abdominis and internal oblique muscle which was repaired and meshplasty was done.<\/jats:p>\n               <jats:p>Delayed presentation and ignorance towards \u2018handlebar sign\u2019 is associated with visceral injury (haematoma\/perforation) will incur the risk of rising morbidity and mortality. With CT scan we can assess the abdominal cavity to rule out associated visceral or vascular injury. Surgical repair for restoring disrupted anatomy with or without meshplasty is the preferred approach.<\/jats:p>","DOI":"10.1136\/bcr-2019-231835","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T09:41:31Z","timestamp":1573206091000},"page":"e231835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Handlebar sign: a bruise with underlying visceral injury"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1083-3458","authenticated-orcid":false,"given":"Vijay Waman","family":"Dhakre","sequence":"first","affiliation":[{"name":"Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarvesh B","family":"Kadam","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhilesh","family":"Gowda","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,7]]},"reference":[{"key":"2025082800442693000_12.11.e231835.1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922814526977"},{"key":"2025082800442693000_12.11.e231835.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-005-0338-6"},{"key":"2025082800442693000_12.11.e231835.3","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1016\/j.jpedsurg.2012.02.003","article-title":"Traumatic abdominal wall hernias: an emerging trend in handlebar injuries","volume":"47","author":"Rathore","year":"2012","journal-title":"J Pediatr Surg"},{"key":"2025082800442693000_12.11.e231835.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.11.015"},{"key":"2025082800442693000_12.11.e231835.5","doi-asserted-by":"crossref","unstructured":"Upasani A , Bouhadiba N . Paediatric abdominal wall hernia following handlebar injury: should we diagnose more and operate less? BMJ Case Rep 2013;2013. doi:doi:10.1136\/bcr-2012-008501. [Epub ahead of print: 19 Apr 2013].","DOI":"10.1136\/bcr-2012-008501"},{"key":"2025082800442693000_12.11.e231835.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.epsc.2016.02.005","article-title":"Blunt abdominal trauma with handlebar injury: a rare cause of traumatic amputation of the appendix associated with acute appendicitis","volume":"7","author":"Jensen","year":"2016","journal-title":"J Pediatr Surg Case Rep"},{"key":"2025082800442693000_12.11.e231835.7","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.annemergmed.2017.04.049","article-title":"Adolescent male with abdominal pain","volume":"70","author":"Wijekoon","year":"2017","journal-title":"Ann Emerg Med"},{"key":"2025082800442693000_12.11.e231835.8","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s10029-003-0203-4","article-title":"Traumatic abdominal wall hernia: a reappraisal","volume":"8","author":"Kumar","year":"2004","journal-title":"Hernia"},{"key":"2025082800442693000_12.11.e231835.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7297.1288"},{"key":"2025082800442693000_12.11.e231835.10","doi-asserted-by":"crossref","unstructured":"Biswas S , Vedanayagam M , Hipkins G , et al . Acute direct inguinal hernia resulting from blunt abdominal trauma: case report. World J Emerg Surg 2010;5.doi:10.1186\/1749-7922-5-16","DOI":"10.1186\/1749-7922-5-16"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:44:32Z","timestamp":1756367072000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":10,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,7]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bcr-2019-231835"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231835","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}