Blunt adrenal gland injury: The impact of extra-abdominal injury.

Abstract

Blunt adrenal gland injuries are considered uncommon. Moreover, the factors associated with the mechanisms of the injury following blunt trauma are unclear. In this study, we determined the factors associated with blunt adrenal gland injury (BAGI). A total of 315 patients with blunt abdominal trauma were admitted to our institution during a 12-year period. After excluding 26 patients who were under 18 years old and 27 patients who were in cardiopulmonary arrest on arrival, 262 eligible patients were retrospectively reviewed. Patient characteristics, mechanism of injury, intervention, and associated organ injuries were compared between those with and without BAGI. Blunt adrenal gland injury was identified in 38 of 262 patients (14.5%). The right side was the predominant site of injury (68%). There were no differences in vital sign, in-hospital mortality, intervention, and concomitant abdominal organ injuries between those with and without adrenal gland injury. Patients with BAGI had a higher frequency of fall and motorcycle collision as mechanisms of injury. In addition, patients with BAGI had a higher injury severity score and a higher frequency of concomitant severe head, chest, and pelvic injuries. The results of the present study suggest that the deceleration injury leading to concomitant head, chest, or pelvic injuries with blunt abdominal trauma may be associated with the mechanism of BAGI. Prognostic study, level IV.