Bicycle Handlebar-Related Blunt Abdominal and Pelvic Injuries in Children and Adults: A Radiological Perspective.

Objective: Bicycle handlebar-related abdominopelvic trauma can cause clinically significant injuries despite minimal external signs, potentially resulting in delayed diagnosis. Radiological evidence regarding CT injury patterns associated with this mechanism remains limited. This study aimed to evaluate and characterize the CT findings of bicycle handlebar-related blunt abdominal and pelvic injuries in pediatric and adult patients and to describe injury patterns, organ involvement, and clinical management.

Materials and methods: This retrospective study included patients who presented with bicycle handlebar-related abdominopelvic injuries between July 2010 and November 2025. Patients who underwent contrast-enhanced abdominopelvic CT because of suspected abdominopelvic trauma were analyzed. CT findings were categorized and graded using the AAST injury scale.

Results: Twenty-three patients had CT findings indicative of abdominopelvic injury, with a total of 25 distinct injuries identified. Nineteen patients (82.6%) were pediatric patients aged 6-16 years, and 4 (17.4%) were adults aged 21-30 years; 86.9% were male. The most common organ injuries involved the spleen (24%) and liver (20%). CT was performed within 24 hours in 87.0% of patients, whereas delayed imaging occurred in 13.0%. Of the 19 intra-abdominal organ injuries, 89.5% were AAST grades 1-3, and 10.5% were grades 4-5. Most patients (82.6%) were managed conservatively, whereas 17.4% required surgical or interventional treatment.

Conclusion: Bicycle handlebar-related trauma is a distinctive mechanism of blunt abdominopelvic injury associated with a broad spectrum of CT findings, predominantly affecting school-aged boys but also occurring in adults. Awareness of characteristic CT patterns and standardized injury grading can facilitate timely diagnosis and appropriate management in both pediatric and adult populations.