Injuries and wounds: handlebar injury: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Injuries and wounds: handlebar injury

Sample item

A 9-year-old boy falls from his bicycle and the end of the handlebar strikes the upper abdomen. Two days later he has vomiting and epigastric pain, and the amylase is raised. Which structures are typically injured?

ADuodenum and pancreasBLiver and gallbladderCStomach and transverse colonDSpleen and left kidney

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Duodenum and pancreas

A narrow blunt object driven into the upper abdomen compresses the duodenum and pancreas against the vertebral column. Such handlebar injuries may be delayed in presentation, with pancreatitis or a duodenal haematoma. This pattern should also raise concern for inflicted injury in young children.

Option by option

A. Duodenum and pancreas (correct)
Correct. The retroperitoneal duodenum and pancreas are crushed against the spine.
B. Liver and gallbladder
Liver injury is more common with right-sided blows or lower rib fractures.
C. Stomach and transverse colon
The stomach and transverse colon are mobile and less often injured by this mechanism.
D. Spleen and left kidney
Splenic and renal injury follow flank impacts and cause left upper quadrant pain and haematuria.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Duodenum and pancreas. A narrow blunt object driven into the upper abdomen compresses the duodenum and pancreas against the vertebral column.

Why is "Liver and gallbladder" not the answer?

Liver injury is more common with right-sided blows or lower rib fractures.

Why is "Stomach and transverse colon" not the answer?

The stomach and transverse colon are mobile and less often injured by this mechanism.

Why is "Spleen and left kidney" not the answer?

Splenic and renal injury follow flank impacts and cause left upper quadrant pain and haematuria.

What concept does this question test?

It tests Injuries and wounds: handlebar injury in Forensic Medicine. Such handlebar injuries may be delayed in presentation, with pancreatitis or a duodenal haematoma. This pattern should also raise concern for inflicted injury in young children.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries and wounds: handlebar injury?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.