J Acute Care Surg.  2019 Apr;9(1):7-11. 10.17479/jacs.2019.9.1.7.

Review of the Clinical Characteristics of Adrenal Gland Injury Following Blunt Trauma in a Single Institution

Affiliations
  • 1Department of Critical Care Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 2Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. medhun@hanmail.net

Abstract

PURPOSE
Adrenal gland injuries in trauma are rare and usually misdiagnosed or underestimated in an emergency setting because they are asymptomatic and associated with severe abdominal injuries. This paper reviews the clinical characteristics of adrenal injuries.
METHODS
A retrospective analysis of trauma patients who visited the authors' emergency center was performed from March, 2010 to December, 2017. The patient demographic data, injury mechanism & associated injuries, injury severity score, hospital stay, and mortality were retrieved and analyzed.
RESULTS
Adrenal gland injuries were found in 52 patients: 73.1% (n=38) were males and the mean age was 43.6 years. Of the patients, 84.6% (n=44) had ISS ≥15. Right adrenal gland injuries occurred in 82.7% (n=43). The mechanism of injury was falls in 30.8% (n=16), motor vehicle accidents in 25.0% (n=13), and pedestrian accidents in 23.1% (n=12). Associated injures were liver injury (58.5%), rib fracture (52.8%), kidney injury (24.5%), pelvic bone fracture (20.8%), spine fracture (28.3%), and spleen injury (13.2%). The mean hospital stay was 34.2 days, and the intensive care unit stay was 9 days. The mortality rate was 3.8% (n=2).
CONCLUSION
Adrenal gland injuries are common in males and frequent in the right side. Falls are the leading cause of injury. Most injuries have an associated injury at the abdominal or thoracic region. Adrenal injury is accompanied by high injury severity but showed a good prognosis.

Keyword

Adrenal gland injury; Trauma; Abdominal injury; Injury severity score

MeSH Terms

Abdominal Injuries
Accidental Falls
Adrenal Glands*
Emergencies
Humans
Injury Severity Score
Intensive Care Units
Kidney
Length of Stay
Liver
Male
Mortality
Motor Vehicles
Pelvic Bones
Prognosis
Retrospective Studies
Rib Fractures
Spine
Spleen
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