Bilateral adrenal hemorrhage after blunt trauma: diagnosis by computed tomography

The patient described here had bilateral adrenal hemorrhage due to blunt trauma from a motor vehicle accident. At no time during the patient's hospitalization nor in the year since the accident has he had signs or symptoms suggestive of adrenal insufficiency. The diagnosis of adrenal hemorrhage was made on the basis of changes seen on initial abdominal computed tomography. A 26% incidence of adrenal hemorrhage in patients dying after severe trauma has been established from postmortem examinations, but the overall incidence in trauma patients is not known. Abdominal CT scans may show this entity where it otherwise might not be suspected, particularly since adrenal insufficiency is infrequent.