Advertisement

World Journal of Surgery

, Volume 34, Issue 8, pp 1971–1974 | Cite as

Adrenal Injury Following Blunt Abdominal Trauma

  • Yong Sang Lee
  • Jong Ju Jeong
  • Kee-Hyun Nam
  • Woong Youn Chung
  • Hang-Seok ChangEmail author
  • Cheong Soo Park
Article

Abstract

Background

Adrenal injury secondary to abdominal trauma is quite rare because the adrenal gland is located deep in the retroperitoneum and is well cushioned by surrounding soft tissues. This report presents our experiences of managing patients with adrenal injury following abdominal blunt trauma.

Methods

The medical records of 11 patients who had been treated for adrenal gland injury between January 1998 and June 2009 were retrospectively reviewed.

Results

Of the 11 patients, nine were male and two were female and the mean age was 31.5 years. The causes of trauma were motor vehicle accident (8 cases) and fall (3 cases). The majority of injuries occurred on the right side (8 cases), two were on the left side, and one patient had bilateral injury. Three cases presented as isolated adrenal gland injuries, and eight were combined with other internal organ injuries. The most common coinjured organ was the liver, followed by the kidney. The most useful diagnostic modality was computed tomography (CT). Ten cases were treated successfully using conservative management, while one required a left partial adrenalectomy and splenectomy due to active bleeding.

Conclusions

Adrenal injury due to blunt abdominal trauma is extremely rare. The majority of cases can be diagnosed using CT. Most cases involve the right side and can be treated successfully using conservative management. Surgery is required only in cases of active bleeding.

Keywords

Adrenal Gland Inferior Vena Cava Active Bleeding Motor Vehicle Accident Blunt Abdominal Trauma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Burks DW, Mirvis SE, Shanmuganathan K (1992) Acute adrenal injury after blunt abdominal trauma: CT findings. AJR Am J Roentgenol 158:503–507PubMedGoogle Scholar
  2. 2.
    Roberts JL (1996) CT of abdominal and pelvic trauma. Semin Ultrasound CT MR 17:142–169CrossRefPubMedGoogle Scholar
  3. 3.
    Sinelnikov AO, Abujudeh HH, Chan D et al (2007) CT manifestations of adrenal trauma: experience with 73 cases. Emerg Radiol 13:313–318CrossRefPubMedGoogle Scholar
  4. 4.
    Stawicki SP, Hoey BA, Grossman MD et al (2003) Adrenal gland trauma is associated with high injury severity and mortality. Curr Surg 60:431–436CrossRefPubMedGoogle Scholar
  5. 5.
    Gómez RG, McAninch JW, Carroll PR (1993) Adrenal gland trauma: diagnosis and management. J Trauma 35:870–874CrossRefPubMedGoogle Scholar
  6. 6.
    Pinto A, Scaglione M, Pinto F et al (2003) Adrenal injuries: spectrum of CT findings. Emerg Radiol 10:30–33PubMedGoogle Scholar
  7. 7.
    Sevitt S (1955) Post-traumatic adrenal apoplexy. J Clin Pathol 8:185–194CrossRefPubMedGoogle Scholar
  8. 8.
    Greendyke R (1965) Adrenal hemorrhage. Am J Clin Pathol 43:210–215PubMedGoogle Scholar
  9. 9.
    Branney SW, Wolfe RE, Moore EE et al (1995) Quantative sensitivity of ultrasound in detecting free intraperitoneal fluid. J Trauma 39:375–380CrossRefPubMedGoogle Scholar
  10. 10.
    Ochsner MG, Knudson MM, Pachter HL et al (2000) Significance of minimal or no intraperitoneal fluid visible on CT scan associated with blunt liver and splenic injuries: a multicenter analysis. J Trauma 49:505–510CrossRefPubMedGoogle Scholar
  11. 11.
    You JS, Chung SP, Park YS et al (2007) Isolated adrenal hemorrhage after minor blunt trauma. Am J Emerg Med 25:984.e5CrossRefGoogle Scholar
  12. 12.
    Igwilo OC, Sulkowski RJ, Shah MR et al (1999) Embolization of traumatic adrenal hemorrhage. J Trauma 47:1153–1155CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Yong Sang Lee
    • 1
  • Jong Ju Jeong
    • 1
  • Kee-Hyun Nam
    • 1
  • Woong Youn Chung
    • 1
  • Hang-Seok Chang
    • 1
    Email author
  • Cheong Soo Park
    • 1
  1. 1.Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulKorea

Personalised recommendations