DOCTOR'S VIEW ARCHIVE
Liver Injury from Mountain Biking
As mountain biking has grown in popularity, so have injuries from the sport. Head injuries are relatively common and are responsible for most of the fatalities in mountain bikers. It now seems the head is not alone in its vulnerability.
An increase in liver trauma has now been discovered due to mountain biking. Of 52 patients admitted to the trauma service at the University Hospital of Innsbruck, Austria between 1995 and 1997 with injuries from riding mountain bikes, 8 were found to have had a bleed around the liver. In every case, the handlebars had been driven into the right upper part of the abdomen, right where the liver is located.
The cyclists with liver injuries all had abdominal pain and tenderness in the right upper-quadrant of the abdomen. The largest bleed around the liver had an diameter of 18 cm (7 inches). The liver injuries were managed conservatively with an initial stay in intensive care and then gradual mobilization. All resolved completely after an observation period of 3 months.
These findings were reported by Drs. H Nehoda and B W Hochleitner in the January 31 issue of the medical journal The Lancet in a communication entitled "Subcapsular liver haematomas caused by bar ends in mountain-bike crashes" (Lancet volume 351, page 342, 1998).
All of the mountain bikers with liver injuries had fitted their bicycle handles with bar ends, grip attachments to assist in climbing. Judging from the skin marks, it was apparent that the unfortunate cyclists had fallen on their bar ends.
The bar ends should be forward-inclined and foam covered, recommend the Austrian researchers, and we should "watch out carefully for liver injuries caused by mountain-bike accidents."