Isolated gastric perforation in a child following bicycle handlebar injury: A case report

Handlebar injuries are a significant cause of blunt abdominal trauma in children, ranging from minor contusions to severe organ damage. Gastric perforation following such trauma is rare but potentially life-threatening. A 10-year-old boy presented with acute abdominal pain after a bicycle handlebar injury that occurred shortly after food intake. Physical examination revealed generalized abdominal tenderness and a circular abrasion over the right paraumbilical region. Laboratory investigations showed leukocytosis with normal pancreatic enzyme levels. Contrast-enhanced abdominal CT demonstrated pneumoperitoneum and a clearly visualized full-thickness defect in the anterior gastric wall, with no associated solid organ injuries. Emergency exploratory laparotomy confirmed an isolated gastric perforation, which was repaired using a two-layer primary closure. The postoperative course was uneventful. A nasogastric tube was maintained for 48 hours. Oral feedings were initiated on postoperative day five without doing a contrast study. The patient was discharged on postoperative day seven. Gastric perforation must be considered in children who sustain a handlebar injury.