Ureteric Transection with Jejunal Injury Secondary to Bicycle Handle Bar Penetrating Injury in a 13 Year Old Boy

Ojas Vijayanand Potdar *

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Mohammed Ayub Karamnabi Siddiqui

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Vivek Shaw

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Kaustubh Vaidya

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Prashant Sarawade

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Shashank Sharma

Grant Medical College and J. J. Group of Hospitals, Mumbai, India.

Amrita Patkar

Bharatratna Dr. Babasaheb Ambedkar Municipal General Hospital, Kandivali (W.), Mumbai, Maharashtra, India.

*Author to whom correspondence should be addressed.


Abstract

Background: Ureteric trauma is rare, occurring in <1% of all traumas. Bicycle handlebar injury is a unique trauma mechanism especially noticed in childhood.

Case Presentation: We present a unique case of a 13-year-old male who sustained a penetrating abdominal injury from a bicycle handlebar. Upon initial examination there was herniation of bowel through the abdominal wound, so exploratory laparotomy was performed. There was  transection of the jejunum at a distance of 10 cm from the duodeno-jejunal flexure with more than 75 % of the circumference     of the jejunum and there was transection of the upper one third of left ureter near the left renal pelvis with foreign body (child’s cloth remnant) seen which was initially managed by placement of an infant feeding tube as a bridge between the two transected ends owing to a defect of 3 cm as a temporary emergency salvage procedure. He then underwent per cutaneous nephrostomy insertion. After 3 months, patient underwent definitive repair by left sided pyeloureterostomy over a DJ stent.

Conclusion: This case demonstrates the emergency and delayed definitive management of ureteric transection and jejunal injury secondary to penetrating bicycle handlebar injury.

Keywords: Ureter, jejunal, bicycle, handlebar, penetrating


How to Cite

Potdar , O. V., Siddiqui , M. A. K., Shaw , V., Vaidya , K., Sarawade , P., Sharma , S., & Patkar , A. (2023). Ureteric Transection with Jejunal Injury Secondary to Bicycle Handle Bar Penetrating Injury in a 13 Year Old Boy. Asian Journal of Research and Reports in Urology, 6(1), 21–26. Retrieved from https://journalajrru.com/index.php/AJRRU/article/view/87

Downloads

Download data is not yet available.

References

Debbink KP, Tashjian DB, Tirabassi MV, Gaffey R, Nahmias J. Ureteric transection secondary to penetrating handlebar injury. Trauma Case Reports. 2017;10:16-8.ISSN 2352-6440 Available:https://doi.org/10.1016/j.tcr.2017.07.002.

Karaman A, Karaman MK, Aslan D, Erdoğan YH, Cavuşoğlu O. Tütün. A hidden danger of childhood trauma: bicycle handlebar injuries, Surg. 2009;39(7):572–574.

Nadler EP, Potoka DA, Shulz BL, Morrison KE, Ford HR, Gaines BA. The high morbidity associated with handlebar injuries in children, J. Trauma. 2005;58 (6):1171–1174.

Goliath J, Mittal V, McDonough J. Traumatic handlebar hernia: a rare abdominal wall hernia, J. Pediatr. Surg. 2004;39(10):20–22.

Clarnette TD, Beasley SW. Handlebar injuries in children: patterns and prevention, Aust. N. Z. J. Surg. 1997;67 (6):338.

Brandes SB, Chelsky MJ, Buckman RF, Hanno RM. Ureteral injuries from penetrating trauma, J. Trauma. 1994;36(6): 766–769

Presti JC, Jr., Carroll PR, McAninch JW. Ureteral and renal pelvic injuries from external trauma: diagnosis and management, J. Trauma. 1989;29(3):370–374.

Siram SM, Gerald SZ, Greene WR, et al., Ureteral trauma: patterns and mechanisms of injury of an uncommon condition, Am. J. Surg. 2010;199:566–570.

Medina D, Lavery R, Ross SE, Livingston DH. Ureteral trauma: Preoperative studies neither predict injury nor prevent missed injuries, J. Am. Coll. Surg. 1998;186:641–644.

Pereira BMT, Ogilvie MP, Gomez-Rodriguez JC, et al., A review of ureteral injuries after external trauma, Scand. J. Trauma. 2010;18(6).