Acta Chirurgica Belgica最新文献

{"title":"Langenbeck's legacy to the specialty of abdominal wall and hernias: father, Conrad Johan Martin L. and son, Maximilian Adolf L.","authors":"A Moreno-Egea, C Moreno-Latorre, A Moreno-Latorre","doi":"10.1080/00015458.2026.2668364","DOIUrl":"https://doi.org/10.1080/00015458.2026.2668364","url":null,"abstract":"<p><strong>Background: </strong>The history of inguinal hernia surgery has gone through many stages of development, but none as intense as the radical cure stage. Of the founding fathers of the specialty, history has left out Conrad Johan Martin Langenbeck and forgotten his son, Maximilian Adolf.</p><p><strong>Objective: </strong>Analyze the importance of the Langenbecks, Father and Son, in relation to the specialty of Abdominal Wall and Hernias.</p><p><strong>Results: </strong>The contributions of the Langenbecks, father and son, to the anatomical and surgical science of hernias were remarkable and groundbreaking, especially in the challenging pre-antiseptic era. Their studies and experiences were fundamental to understanding current surgical practices for hernia repair. The research presented in this article demonstrates the individual legacy of the Langenbecks in both the anatomy and surgery of inguinal hernias.</p><p><strong>Conclusions: </strong>The Langenbecks championed the role of the university-trained anatomical surgeon as essential for operating on hernias with low morbidity; they were pioneers in adapting personalized treatment and laid the groundwork for understanding the posterior approach and plug hernioplasty. History should recognize them as the founding fathers of the specialty.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term predictors of morbidity and mortality after surgery for transposition of the great arteries.","authors":"Cynthia Yijing Chan, Pierre Wauthy","doi":"10.1080/00015458.2026.2659698","DOIUrl":"10.1080/00015458.2026.2659698","url":null,"abstract":"<p><strong>Background: </strong>Dextro-transposition of the great arteries is one of the most common cyanotic congenital heart diseases in newborns. Today's first-choice surgery is the arterial switch. This study aims to analyze predictors (<30 postoperative days) of short-term morbidity and mortality after arterial switch at HUDERF and to compare them between simple (without VSD) and complex transpositions (with VSD with/without left/right ventricular outflow tract obstruction or aortic arch anomalies) and between premature and full-term newborns.</p><p><strong>Methods: </strong>A retrospective single-center cohort study was conducted, reviewing the records of patients with transposition of the great arteries operated at HUDERF between 1997-2023. Patients were divided into simple and complex transpositions, and premature and full-term newborns.</p><p><strong>Results: </strong>171 patients were included: 113 simple transpositions and 58 complex. In the early postoperative period, seven (4%) patients died, 89 (52%) had heart failure, and 3 (2%) had myocardial ischemia. 33 (19%) had pulmonary stenosis. Complex morphology was a risk factor for early morbidity and mortality (<i>p</i> = 0.01). Premature newborns had higher morbidity and mortality rates than full-term newborns (12% vs 3%). Early reoperation was performed in 15 patients (9%) and late in 9 (6%). Complex morphology was a risk factor for early (<i>p</i> = 0.0047) and late reoperation (<i>p</i> = 0.048).</p><p><strong>Conclusions: </strong>Early morbidity, early mortality and reoperation rates were higher in complex transpositions, particularly among premature newborns. Heart failure and pulmonary stenosis were the most common early complications. Heart failure was the main factor associated with early mortality. Pulmonary stenosis was one of the most frequent causes of reoperations.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathoracic stomach ischemia successfully treated with gastric imbrication - a case report and literature review.","authors":"Arianna Vittori, Andrés R Latorre-Rodríguez, Sumeet K Mittal","doi":"10.1080/00015458.2026.2660766","DOIUrl":"10.1080/00015458.2026.2660766","url":null,"abstract":"<p><strong>Background: </strong>The management of large paraesophageal hiatal hernias (PEH) is challenging as most patients are elderly with multiple comorbidities. Furthermore, compared to elective procedures, emergency interventions are often associated with even greater complexity. Laparoscopic PEH repair is generally considered safe and feasible, even in urgent cases; however, complications such as acute incarceration and its progression to stomach wall necrosis, which usually requires resection, carries a high risk of morbidity and mortality.</p><p><strong>Methods: </strong>We present a case of acute PEH incarceration with gastric ischemia. Additionally, we conducted a narrative literature review to examine cases of gastric ischemia secondary to acute hiatal hernia strangulation.</p><p><strong>Results: </strong>A 71-year-old man presented with abdominal pain, nausea, and retching. Computed tomography on admission revealed an intrathoracic stomach without signs of complication, while endoscopy showed an ischemic fundus. The patient underwent laparoscopic hiatal hernia repair and gastric imbrication of the ischemic area. At the three-month follow-up, the patient reported no complaints. Twenty-two fully described cases in the literature were retrieved.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first reported case of a patient successfully treated with laparoscopic reduction of a hiatal hernia followed by imbrication of the ischemic area. The procedure resulted in a favorable outcome without the need for resection and reconstruction. Moreover, our literature review represents the first effort to collect data on this rare and complex condition, providing further insight into its presentation and management.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence patterns after primary surgery and neoadjuvant chemoradiotherapy for esophageal adenocarcinoma.","authors":"Andreas Bouckaert, Johnny Moons, Toni Lerut, Willy Coosemans, Jeroen Dekervel, Lieven Depypere, Yannick Mandeville, Hans Van Veer, Philippe Nafteux","doi":"10.1080/00015458.2026.2655680","DOIUrl":"10.1080/00015458.2026.2655680","url":null,"abstract":"<p><strong>Background: </strong>Our publication <i>Across the CROSS in daily practice</i> challenged the routine use of neoadjuvant chemoradiotherapy (nCRT) for locally advanced esophageal adenocarcinoma, showing a comparable 5-year overall survival after primary surgery. Disease-free survival, however, did show a tendency towards higher recurrence rates in the primary surgery group, although not reaching statistical significance. This current study aims to differentiate recurrence patterns and its final impact on overall survival.</p><p><strong>Methods: </strong>This retrospective cohort study with propensity score-matched analysis included all surgically treated patients between 2000 and 2018 with locally advanced adenocarcinoma (cT_1/2N₊ or cT_3/4N_0/+). Exclusion criteria of the CROSS trial were applied. Patients were matched on age, Charlson comorbidity score, clinical tumor length, and lymph node status. Primary end point was time to recurrence.</p><p><strong>Results: </strong>One hundred and forty-nine propensity score-matched cases were defined in each group. Primary surgery resulted in more recurrences (73.2% vs. 57.0%, <i>p</i> = 0.003). However, nCRT resulted in a shorter time to overall recurrence (6.3 vs. 11.5 months, <i>p</i> = 0.004) and locoregional recurrence (6.3 vs. 13.6 months, <i>p</i> = 0.005). Additionally, overall survival after diagnosis of recurrence was significantly shorter for nCRT than for primary surgery (6.9 vs. 9.6 months, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Our propensity score-matched results indicate that both overall and locoregional recurrences occur significantly earlier in nCRT patients and overall survival after recurrence is significantly shorter after nCRT. These findings might explain the comparable 5-year overall and disease-free survival of both groups.<b>Abbreviations:</b> CROSS: trial chemoradiotherapy for oesophageal cancer followed by surgery study; CT scan: computed tomography scan; HR: hazard ratio; nCRT: neoadjuvant chemoradiotherapy.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailored Charles' procedure and vascularized lymph node transfer for advanced stage Klippel-Trenaunay syndrome.","authors":"Pedro Ciudad, Joseph M Escandón, Juste Kaciulyte, Oscar J Manrique, Michele Maruccia, Chang-Cheng Chang, Hung-Chi Chen","doi":"10.1080/00015458.2026.2644337","DOIUrl":"10.1080/00015458.2026.2644337","url":null,"abstract":"<p><strong>Background: </strong>Klippel-Trenaunay syndrome (KTS) is primarily managed for vascular and soft-tissue abnormalities, while treatment of associated lymphedema remains poorly described. This study outlines our protocol for advanced lower-extremity lymphedema using a combined modified Charles' procedure and vascularized lymph node transfer (VLNT).</p><p><strong>Methods: </strong>KTS patients with International Society of Lymphology (ISL) stage III lower-limb lymphedema treated between 1999 and 2018 were retrospectively reviewed. All underwent a modified Charles' excisional procedure with Homans techniques and VLNT. Outcomes were assessed at least one year postoperatively, focusing on early complications and postoperative hospital admissions for residual disease or recurrent infections.</p><p><strong>Results: </strong>Twenty-two patients (14 male, 8 female) with a mean age of 21 years (range, 4-41) were included. Average time since KTS diagnosis was 14 years (range, 3-26). VLNT donor sites included groin (18.2%), supraclavicular (31.8%), and gastroepiploic (50%). Mean hospital stay was 16 days (range, 14-39). Follow-up averaged 38 months (range, 27-45). Three minor complications occurred (one wound dehiscence, one infection, one bleeding), and flap survival was 100%. Annual hospital admissions for soft-tissue infections decreased from a preoperative mean of 3.5 to 1.2 postoperatively. Patients required an average of 3.5 additional procedures (range, 2-8) to remove residual hemangiolymphangioma.</p><p><strong>Conclusions: </strong>Lymphedema in KTS presents unique challenges and differs markedly from typical primary or secondary lymphedema. Effective management requires meticulous assessment and individualized planning. In this population, functional improvement is the main objective, and extensive debulking procedures combined with physiologic reconstruction may provide meaningful clinical benefit despite limited aesthetic outcomes.</p><p><strong>Article highlights: </strong><b>Type of Research:</b> Single-center, retrospective, cohort study<b>Take Home Message:</b> In severe lymphedema of patients diagnosed with KTS, single excisional or physiological surgical treatment is insufficient to fight the totality of pathologic processes at work. A combination of varied techniques that act on different disease's features can achieve significantly better outcomes.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current concepts in falciform ligament hernia diagnosis and treatment. A systematic review.","authors":"Epameinondas Stratopoulos, Georgios Papadopoulos, Despoina Sidira, Dimitrios Filippou","doi":"10.1080/00015458.2026.2648301","DOIUrl":"10.1080/00015458.2026.2648301","url":null,"abstract":"<p><strong>Background: </strong>Falciform ligament hernia (FLH) is a highly uncommon type of internal hernia. This internal hernia presents diagnostic difficulties due to its ambiguous clinical symptoms, which can resemble other causes of acute abdominal pain.</p><p><strong>Methods: </strong>A systematic literature review of cases of falciform ligament hernia was conducted on 5th December 2024 according to PRISMA guidelines and using PubMed and Google Scholar databases.</p><p><strong>Results: </strong>Among 103 articles, 36 were included in our review. In total 50 patients were reported. The median age at diagnosis was 41 years. Upper abdominal pain and vomiting were the predominant symptoms. Computed Tomography (CT) scan was instrumental in detecting this rare hernia. Despite this, a definitive diagnosis is often established in the surgical setting. The causes of FLH are diverse, including both congenital and acquired elements. Congenital factors (70%) may involve embryological defects or complete failure in the development of the falciform ligament. Acquired causes might stem mainly from previous abdominal procedures (28%) or injuries (2%). The small bowel was responsible for 78% of cases. Emergency laparotomy was performed in 70% of patients, while 28% were managed with laparoscopy.</p><p><strong>Conclusion: </strong>The treatment for FLH is solely surgical. Laparoscopic methods are preferred, providing faster recovery, enhanced visualization for reducing the hernia, and assessing bowel viability. In cases of severe complications such as bowel ischemia and perforation, open surgery may be necessary. Prompt surgical intervention is crucial to achieve a positive outcome and reduce morbidity.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving triage and recycling of surgical waste at a pediatric hospital - a pilot study.","authors":"Weronika Kopytek, Louise Raeymaekers, Helena Reusens, Víola B Weeda","doi":"10.1080/00015458.2026.2641489","DOIUrl":"10.1080/00015458.2026.2641489","url":null,"abstract":"<p><strong>Background: </strong>Within the medical industry, operating rooms contribute significantly to greenhouse gas emissions. As a pediatric hospital, we feel highly responsible to reduce the negative impact of healthcare aimed at improving young lives. Therefore, we conducted a pilot study to assess simple waste segregation and recycling strategies aimed at reducing waste and improving sorting and recycling in our operating quarters.</p><p><strong>Methods: </strong>The study was conducted at Hôpital Universitaire Des Enfants Reine Fabiola (HUDERF)'s operating quarters and consisted of a questionnaire addressing staff opinions and waste measurements before (<i>T</i> = 0) and after (<i>T</i> = 1) a weeklong intervention: a campaign aimed at improving sorting and recycling surgical waste and reducing unnecessary opening of materials.</p><p><strong>Results: </strong>Participants agreed that a transition towards more sustainable operating quarters will be necessary. At <i>T</i> = 1, 53% of respondents considered measures for sustainable waste management were applied, versus 26% before. Fifty-one surgeries were analyzed at <i>T</i> = 0. The mean weight of waste to incinerate was 1780 gram per hernia/orchidopexy, 940 gram per circumcision, and 2150 gram per central venous catheter (CVC) placement. At <i>T</i> = 1, another 51 surgeries were analyzed. The mean weight of waste to be incinerated was 665 gram per hernia/orchidopexy, 445 gram per circumcision, and 920 gram per CVC placement.</p><p><strong>Conclusion: </strong>Simple, easy-to-implement measures introduced during a one-week campaign aimed at improved triage and diminished pre-emptive opening of sterile materials led to <i>a</i> > 50% reduction in waste to incinerate.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullying, undermining behavior, and harassment during general surgery training in Belgium: a national cross-sectional survey.","authors":"Francesca Tozzi, Gilles Soenens, Halima Guelai, Effa Altaf, Isabelle Van Herzeele, Frederik Berrevoet, Niki Rashidian","doi":"10.1080/00015458.2026.2633016","DOIUrl":"10.1080/00015458.2026.2633016","url":null,"abstract":"<p><strong>Background: </strong>Bullying, undermining behavior, and harassment (BUBH) persist as ongoing concerns in healthcare, particularly within stressful environments. This study aims to explore the prevalence and characteristics of BUBH among Belgian general surgery residents.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed online using an anonymous link through newsletters and social media channels of the Belgian Association of Surgical Trainees. The survey comprised 54 questions including: A) demographic; B) instances of BUBH, adapted from the validated Leymann Inventory of Psychological Terror and the Negative Acts Questionnaire; C) reporting, perpetrators, and management of BUBH derived from the survey developed by Rouleaux Club (United Kingdom).</p><p><strong>Results: </strong>Fifty-six surgical residents, aged 24 to 40 years, participated. Of them, 18 (32%) were junior, 26 (56%) senior, and seven (12%) were enrolled in a research trajectory. Most respondents were Caucasian (82%), female (61%), heterosexual (93%), and without disability (98%). BUBH was experienced by 38 (68%) residents, while 44 (79%) witnessed BUBH towards their colleagues. Main perpetrators were consultants (<i>n</i> = 40/132; 30%) and nursing staff (<i>n</i> = 28/132; 21%). Reported behaviors included an unmanageable workload (<i>n</i> = 53; 95%), ignored opinions, (<i>n</i> = 52; 93%) and working below competence (<i>n</i> = 51; 91%). BUBH primarily occurred in operating rooms (39%), hospital wards (34%), or emergency rooms (11%).</p><p><strong>Conclusion: </strong>This is the first national study examining BUBH during surgical training in Belgium. Results highlight how BUBH is often misidentified and underreported. Proactive measures, educational programs, and support networks are essential to effectively address and mitigate these issues.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-13"},"PeriodicalIF":0.8,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic role of Hashimoto's thyroiditis in papillary thyroid carcinoma: insights from a single-center cohort study.","authors":"Mahmut Yilmaz, Aytekin Unlu, Ismail Hakki Ozerhan, Oner Mentes","doi":"10.1080/00015458.2026.2636118","DOIUrl":"10.1080/00015458.2026.2636118","url":null,"abstract":"<p><strong>Background: </strong>Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disorder, while papillary thyroid carcinoma (PTC) is the most prevalent thyroid malignancy. The association between HT and PTC remains debated, with some studies suggesting a protective effect of HT against aggressive PTC features. This study explores the relationship between HT and PTC in a single-center cohort, focusing on clinicopathological and prognostic factors.</p><p><strong>Methods: </strong>This retrospective study included adult patients who underwent thyroid surgery between 2009 and 2017. Patients were divided into two groups: those with concurrent PTC and HT (Group 1, <i>n</i> = 68) and those with PTC alone (Group 2, <i>n</i> = 329). Demographic, laboratory, and pathological data were compared using appropriate statistical analyses.</p><p><strong>Results: </strong>A significant association between HT and PTC was observed (χ²=5.3; <i>p</i> = 0.021; OR: 1.682). Group 1 patients were more often female and significantly younger. TSH levels were higher in Group 1 (<i>p</i> < 0.001), and follow-up duration was longer (<i>p</i> = 0.023). Although the mean tumor diameter was smaller in the HT group, the difference was not statistically significant. No significant differences were found regarding multifocality, capsular invasion, or lymphovascular invasion.</p><p><strong>Conclusion: </strong>The presence of HT appears to be significantly associated with the occurrence of PTC and may be linked to a less aggressive clinical profile, as suggested by younger age and higher TSH levels. The longer follow-up duration observed in HT patients may reflect more vigilant surveillance due to underlying autoimmune pathology. However, the retrospective and single-center design limits generalizability. Prospective, multicenter studies with larger cohorts are warranted to confirm these findings.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular handlebar syndrome in a triathlete: a case report.","authors":"Toon J L Kuypers, Kim Daenens","doi":"10.1080/00015458.2026.2634743","DOIUrl":"10.1080/00015458.2026.2634743","url":null,"abstract":"<p><strong>Background: </strong>Handlebar syndrome has a low incidence and its presentation can be quite different making the diagnosis sometimes challenging.</p><p><strong>Methods: </strong>We present a rare case of the handlebar syndrome in which the handlebar of a bike injures the common femoral artery with an atypical clinical presentation. A written informed consent was obtained from the patient, and the study was approved by the Ethics Committee Research UZ/KU Leuven with the corresponding reference number S70224.</p><p><strong>Results: </strong>The case is a unique late presentation of the handlebar syndrome with only mild symptoms during high-intensity exercise, with normal arterial pulsations and a murmur in the groin. The patient was initially conservatively treated. Although symptoms decreased, there was still a loss of power during maximal intense efforts, and the ankle-brachial index dropped on the bike with a duplex showing low-grade stenosis in the common femoral artery. We performed femoral endarterectomy using a bovine patch. Postoperatively, the patient was symptom-free during intense exercise.</p><p><strong>Conclusion: </strong>Diagnosis could be missed in the absence of early symptoms, posing a risk in children with respect to limb growth and length. Treatment is patient- and lesion-tailored, and mostly performed by open surgery, although conservative management has also been described.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}