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Traumatic adrenal injuries
Lamia Gabal-Shehab1, Madhu Alagiri
1Division of Urology, University of California San Diego Medical Center, San Diego, California 92103-8897, USA.
The Journal of Urology
|March 11, 2005
Summary
Blunt adrenal injuries in children are rare, often occurring with other abdominal trauma. Most cases are self-limiting, rarely requiring intensive care or surgery, though some may need transfusions.
Area of Science:
- Pediatric Traumatology
- Adrenal Gland Injuries
- Abdominal Trauma Management
Background:
- Blunt traumatic adrenal injuries in children are infrequently documented.
- Understanding their prevalence and outcomes is crucial for pediatric trauma care.
Purpose of the Study:
- To determine the prevalence of blunt isolated and nonisolated adrenal injuries in pediatric patients.
- To describe the management and prognosis of these injuries.
Main Methods:
- Analysis of trauma data from a pediatric institution (1991-1998).
- Identification of patients with blunt traumatic adrenal injuries via computerized tomography (CT).
- Detailed chart review for concomitant injuries, treatment, and outcomes.
Main Results:
- 20 adrenal injuries identified in 9,199 pediatric trauma cases (0.22% prevalence).
- Right adrenal gland most frequently injured (85%); 75% were nonisolated injuries.
- Associated injuries included liver (87%) and ipsilateral kidney (53%); 60% of isolated injuries required transfusion.
Conclusions:
- Blunt adrenal injuries are rare in pediatric populations, usually part of multiorgan trauma.
- Right adrenal and liver/kidney injuries are common associations.
- Adrenal trauma is typically self-limited, rarely needing intensive care or surgery.