To expose frequency, distribution, evolution and clinical implications in the traumatic injury of the adrenal glands.

We present a descriptive study of adrenal hemorrhage (AH) in severely injured politrauma patients between the years 2005-2012 (Figs. 1 and 2). From our database of 848 selected trauma patients requiring admission to intensive care unit (ICU) who underwent abdominal computed tomography (CT), we selected cases which included the words "adrenal hemorrhage" or "adrenal hematoma" in the radiology report. We analyzed the following variables: incidence, sex, age, trauma mechanism, location (right or left), fat stranding sign,associated injuries, need for corticosteroid replacement and mortality. Whole body...

Of 848 trauma patients admitted to the ICU for monitoring, we identified 20 cases of AH, ie 2% incidence (similar to other series in the literature). 13 cases were male (65%) and 7 cases were women (35%). The mean age was 46 years (14 years younger and 80 years older). See Figs. 3 and 4. The main mechanisms of trauma were 551 traffic accidents (65%) and 162 falls from a height / falls(19%), with the remaining 135 explained by other mechanisms. The cases were distributed...

The adrenal hemorrhage is an uncommon lesion that affects approximately 2% of severely injured politrauma patients.It’s mostly righ-sided and exceptionally bilateral. Usually, AH does not lead to adrenal insufficiency, a complication that can arise when it is bilateral,needing glucocorticoid replacement. We must be vigilant in severely injured patients to check the adrenal glands, as their damage brings subtle signs that can be associated with severe disease.Although AH itself does not determine the prognosis, implies a high mortality, probably related to associated injuries.

1. Daly KP, Ho CP et al.Traumatic RetroperitonealInjuries: Review of MultidetectorCTFindings. Radiographics2008; 28(6): 1571-90. 2.Rana AI, Kenney PJ et al. Adrenal Gland Hematomas in Trauma Patients. Radiology 2004; 230(3): 669-75. 3. Sinelnikov AO, Abujudeh HH et al.CT manifestations of adrenal trauma: experience with 73 cases. Emerg Radiol. 2007; 13(6): 313-8. 4.Roberts JL, Dalen K et al. CT in abdominal and pelvic trauma. Radiographics 1993; 13(4): 735-52.