Purpose or Case Report: Direct impact upon the bicycle handlebars is an especially harmful mechanism of injury in children. Pediatric patients who present following direct impact of the bicycle handlebars upon the abdomen are much more likely to suffer internal organ injury and require operative intervention than those who present following a bicycle accident without direct impact upon the handlebars.

Unfortunately, bicycle handlebar trauma is not only a damaging mechanism of injury, but also a treacherous one. Physical exam findings can be subtle; these children often appear misleadingly well. Many such children are initially misdiagnosed and sent home prematurely only to re-present. Delays in definitive diagnosis are typical.

The radiologist, therefore, by aiding in the timely identification of injuries and determination of any need for surgery, can make a valuable contribution to patient care.

Our cases include a 9-year-old girl with a puncture wound and abscess in the medial thigh musculature, a 13-year-old male with a penetrating wound to the left lower abdominal quadrant with extensive retroperitoneal and extraperitoneal hematoma and other injuries, a 14-year-old male with a hematoma in the right lower abdominal quadrant, and a 7-year-old boy with a liver laceration, each of whom suffered a bicycle handlebar impact to the abdomen.

As companion cases, we also present a 12-year-old boy with a transected pancreas following an ATV rollover which involved impact of the handlebars upon the abdomen, and a 49-year-old man who sustained a shattered kidney in a bicycle accident.
Methods & Materials:
Results:
Conclusions: