Objectives
Adrenal gland injury is a potentially devastating event if unrecognized in the treatment
course of a trauma patient. We reviewed our single-center experience and outcomes
in patients with adrenal gland trauma.
Methods
We performed a retrospective review of all patients presenting with trauma to the
Regional Medical Center at Memphis who had adrenal gland injuries from January 1991
through March 2006. Each chart was reviewed with attention to the demographics, associated
injuries, complications, and outcomes. Patients were stratified into two subgroups
according to age (35 years or younger and older than 35 years) to allow for an age-based
comparison between the two groups.
Results
Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal
injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients,
125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their
injury diagnosed during exploratory laparotomy. Right-sided injuries predominated
(78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy.
Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic
steroid therapy. Patients older than 35 years were more likely to have complications
such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age
of 35 years or younger was associated with a significantly increased incidence of
liver lacerations.
Conclusions
Adrenal gland injury is uncommon, although mostly associated with greater injury severity.
Although adding to morbidity, most are self-limited and do not require intervention.
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Article info
Publication history
Accepted:
July 2,
2007
Received:
February 12,
2007
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
