Traumatic adrenal haemorrhage : a case report
Introduction: Adrenal injuries are rare, as the adrenal glands lies deep in the abdomen, seemingly protected from blunt abdominal trauma. Computed tomography(CT) is the gold standard for evaluating adrenal gland injuries, where haematoma and active bleeding due to injury to the suprarenal vessels ma...
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| Main Authors: | , , , |
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| Format: | Conference or Workshop Item |
| Language: | English |
| Published: |
2009
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/23328/1/Traumatic_Adrenal_Hge.pdf http://irep.iium.edu.my/23328/ |
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| Institution: | Universiti Islam Antarabangsa Malaysia |
| Language: | English |
| Summary: | Introduction: Adrenal injuries are rare, as the adrenal glands lies deep in the abdomen, seemingly protected from blunt abdominal trauma. Computed tomography(CT) is the gold standard for evaluating adrenal gland injuries, where haematoma and active bleeding due to injury to the suprarenal vessels may be visualized using new multi-detector row CT (MDCT). The prevalence of adrenal haemorrhage among patients with blunt abdominal trauma undergoing CT scanning is 2%, among which 60% occur on the right side, 25% on the left and 15% are bilateral. Depending on the extent of the injury and the patients haemodynamic stability, adrenal haemorrhage is addressed surgically or conservatively.
Case Report: We report a case of 42 years old Malay man who alleged fall from 3 story height and sustained right haemopneumothorax, bilateral lung contusion, fractures of lower right ribs, open fracture right radius and right elbow dislocation. In view of the presence of haematuria, urinary tract injury was suspected and CT scan of the abdomen was done. In addition to the ipsilateral thoracic injury, there were right adrenal and psoas haematoma with fracture right transverse process of L2-L4 vertebra. Other intraabdominal solid organs were intact. Patient was treated conservatively as he was haemodynamically stable.
Conclusions: Blunt adrenal injuries usually present as part of a multiorgan trauma. Familiarity with characteristic CT findings of adrenal trauma is essential for the radiologist to avoid misdiagnosis.
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