Adrenal injury following blunt abdominal trauma

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