Adrenal trauma: Elvis Presley Memorial Trauma Center experience.
OBJECTIVE
Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma.


METHODS
We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at Memphis who had adrenal gland injuries from January 1991 through March 2006. Each chart was reviewed with attention to the demographics, associated injuries, complications, and outcomes. Patients were stratified into two subgroups according to age (35 years or younger and older than 35 years) to allow for an age-based comparison between the two groups.


RESULTS
Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients, 125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their injury diagnosed during exploratory laparotomy. Right-sided injuries predominated (78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy. Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic steroid therapy. Patients older than 35 years were more likely to have complications such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age of 35 years or younger was associated with a significantly increased incidence of liver lacerations.


CONCLUSIONS
Adrenal gland injury is uncommon, although mostly associated with greater injury severity. Although adding to morbidity, most are self-limited and do not require intervention.
Mehrazin
Reza
R
Department of Urology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Derweesh
Ithaar H
IH
Kincade
Matthew C
MC
Thomas
Adam C
AC
Gold
Robert
R
Wake
Robert W
RW
D000293:Adolescent; D000311:Adrenal Glands / Q000293:injuries* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy