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Traumatic adrenal injury in children
1Department of Pediatric Imaging, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. mikischw2@isdn.net.il
Insights
Pediatric blunt abdominal trauma can cause adrenal hemorrhage, affecting the right adrenal gland in nearly 5% of cases. Advanced imaging aids in detecting this overlooked injury in children.
Area of Science:
- Pediatric Traumatology
- Emergency Medicine
- Radiology
Background:
- Multiple organ injury is common in pediatric emergency departments.
- Adrenal hemorrhage is an underrecognized consequence of pediatric trauma.
Observation:
- Computed tomography (CT) evaluated adrenal gland injury in children with blunt abdominal trauma.
- 121 children with blunt abdominal trauma were assessed, with total body CT for severe cases.
Findings:
- Adrenal hemorrhage occurred in 4.95% of pediatric blunt abdominal trauma cases.
- The right adrenal gland was exclusively affected in all identified cases.
- Associated injuries included chest trauma (66.7%) and abdominal organ damage (50%).
Implications:
- Traumatic adrenal injury in children may be more prevalent than previously thought.
- Advanced imaging (CT) improves detection of adrenal injuries in pediatric trauma.
- This highlights the importance of considering adrenal damage in major collision injuries.
Background:
Multiple organ injury in children is an increasingly frequent phenomenon in the modern emergency room. Adrenal hemorrhage associated with this type of trauma has received little attention in the past.
Objectives:
Using computed tomography, we sought to determine the rate and nature of adrenal gland injury in children following blunt abdominal trauma due to motor vehicular accident.
Methods:
A total of 121 children with blunt abdominal trauma were examined and total body CT was performed in cases of multi-organ trauma or severe neurological injury.
Results:
Of all the children who presented with blunt abdominal trauma over a 51 month period, 6 (4.95%) had adrenal hemorrhage. In all cases only the right adrenal gland was affected. Coincidental injury to the chest and other abdominal organs was noted in 66.7% and 50% of patients, respectively.
Conclusions:
Traumatic adrenal injury in the pediatric population may be more common than previously suspected. Widespread application of the more sophisticated imaging modalities available today will improve the detection of damage to the smaller organs in major collision injuries and will help in directing attention to the mechanism of trauma.