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Abdominal Imaging

, Volume 32, Issue 2, pp 248–252 | Cite as

Acute adrenal hemorrhage after blunt trauma

  • O. Ikeda
  • Joji Urata
  • Yushi Araki
  • Shunji Yoshimatsu
  • Shuichi Kume
  • Yoshitsugu Torigoe
  • Yasuyuki Yamashita
Article

Abstract

Objective

To determine the appropriate management of adrenal hemorrhage in patients with severe chest and upper abdominal blunt trauma.

Materials and Methods

We reviewed 7 patients who suffered from severe traumatic adrenal hemorrhage after a traffic accident (n = 4) or fall (n = 3). Contrast-enhanced CT images were analyzed for multi-organ traumatic injury, hematoma size, extravasation, and pseudoaneurysm formation. We also report their management including transarterial embolization (TAE) and follow-up findings.

Results

All 7 patients manifested multi-organ traumatic injury and hemothorax; 5 also had rib fractures, 5 had abdominal organ injuries (liver, n = 3; kidneys, n = 2; pancreas, n = 1); 2 had dorsal fractures, and 1 had a traumatic aortic aneurysm. On CT images, unilateral right adrenal hematomas ranging from 20 to 50 mm (mean 26 mm) in length and from 15 to 50 mm (mean 23 mm) in width were seen. In 6 patients these were localized, and they were followed without any intervention. The other patient had a massive hematoma with pseudoaneurysm and extravasation, who subsequently received TAE. At 3-month follow-up all patients were doing well.

Conclusion

Information regarding the size of the hematoma and the presence of extravasation helps to select the appropriate management of patients with traumatic adrenal hemorrhage. TAE appears to be useful for treating patients with massive adrenal hemorrhage.

Keywords

Acute adrenal hemorrhage Blunt trauma TAE 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • O. Ikeda
    • 1
  • Joji Urata
    • 2
  • Yushi Araki
    • 3
  • Shunji Yoshimatsu
    • 3
  • Shuichi Kume
    • 4
  • Yoshitsugu Torigoe
    • 4
  • Yasuyuki Yamashita
    • 1
  1. 1.Department of Diagnostic RadiologyKumamoto University Graduate School of Medical and Pharmaceutical SciencesKumamotoJapan
  2. 2.Department of RadiologySaiseikai Kumamoto HospitalKumamotoJapan
  3. 3.Department of RadiologyNational Hospital Organization Kumamoto Medical CenterKumamotoJapan
  4. 4.Department of SurgeryNational Health Insurance Ueki Municipal HospitalUeki KamotoJapan

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