title: [Clinical characteristics of adrenal gland trauma].
abstract: OBJECTIVE
  To explore the clinical characteristics of adrenal gland trauma.
  
  
  METHODS
  A retrospective review was performed for 17 patients presenting with adrenal gland injury diagnosed by computed tomography (CT). There were 11 males and 6 females with an average age of 14-60 (38 ± 12) years. The injuries occurred as the consequence of motor vehicle crash (n = 13) and secondarily to a fall (n = 4). The average time from accident to admission was 5.0 ± 4.1 hours and the average injury severity score (ISS) 31.5 ± 10.3. Among 9 patients with throat injuries, there were pulmonary contusion, hematopneumothrax and rib fracture, followed by extremity fracture (n = 8) and pelvis fracture (n = 7). Additionally, 3 patients had injuries to vertebral column and 4 suffered closed cranial injury. There were 3 patients with liver injury, including subcapsular hematoma (n = 2) and laceration (n = 1). The urinary related injuries included renal contusion and laceration (n = 5) and urethral injury (n = 1). Among them, 15 had injuries to right adrenal glands and 2 to left ones. The CT findings of adrenal trauma were adrenal contusion and focal hematoma. All patients received conservative treatment.
  
  
  RESULTS
  No patient died. The complications of urinary tract infection (n = 6) , deep vein thrombosis (n = 3), pneumonia (n = 3) and gastrointestinal ulceration (n = 2) improved with conservative treatment.Vital signs were all stable after 1 week treatment except for 1 patient operated for intracranial hematoma. The average follow-up period was 2.0- 12.0 (5.5 ± 2.7) weeks for 11 patients. The re-examination of CT showed a absorption of hematoma. And 2 cases had a complete absorption.
  
  
  CONCLUSIONS
  Adrenal gland injury is rare and there is a right-sided preponderance.It is associated with high injury severity.For a lack of obvious clinical manifestations, missed diagnosis is frequently made. CT scan is the first-choice diagnostic tool for adrenal gland injury. Conservative treatment is often satisfactory and hormonal supplement unnecessary.
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China. Email: mmanlibo@sohu.com.
authors.forename: Libo
authors.initials: L
authors.lastname: Man
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Guanglin
authors.initials: G
authors.lastname: Huang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Feng
authors.initials: F
authors.lastname: He
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Guizhong
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000293:injuries; D000328:Adult; D005260:Female; D006406:Hematoma; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult