Severe Unilateral Adrenal Hemorrhage in Blunt Abdominal Trauma with Pelvic Fracture

Abstract

Background: Adrenal injuries are rare. In blunt abdominal trauma they are usually a result of a massive trauma force associated with multiple injuries.

Case Study: We report a case in which the adrenal injury led to a large retroperitoneal hematoma causing hemorrhagic shock. Possible trauma mechanisms are critically discussed.

Conclusions: CT is the gold standard for evaluating adrenal gland injuries. Active bleeding due to injury to the suprarenal vessels may be visualized using new CT techniques such as multi-detector row CT (MDCT). Treatment options are based on the patient's stability, associated injuries, and viability of the gland as assessed during surgical exploration. Repair rather than removal is preferred. In unstable patients resection is the operation of choice. Interventional angiography can be an option in stable patients with evident hemorrhage and no large hematoma. Conservative treatment with close surveillance is indicated in isolated trauma with limited hemorrhage.