Adrenal gland injuries are being diagnosed more commonly concurrent to the widespread utilization of modern high resolution computed tomographic (CT) imaging . Adrenal gland trauma has long been associated with increased overall injury severity and mortality, mainly due to the large amount of force required to injure the relatively 'well protected' suprarenal glands [1-2]. Adrenal glands are located in the upper aspect of the perirenal space and are enclosed by the Gerota's fascia .
Advances in CT imaging contributed to higher detection rate of adrenal injuries following blunt trauma -- In fact, up to 25% of severely traumatized patients have been found to have some radiographic evidence of adrenal gland injury [3-5]. Moreover, it has been noted that the mortality associated with adrenal gland trauma has been noted to be five times higher than that associated with non-adrenal gland trauma .
Right-sided adrenal injuries appear to be universally more common [1-2]. Management of adrenal injuries is almost exclusively non-operative, and laparotomy is most often performed for other, associated injuries . In fact, even when a laparotomy is performed for non-adrenal injuries, the adrenal gland is almost never removed unless exsanguinating hemorrhage from the adrenal necessitates such drastic intervention.
Advances in interventional radiologic (IR) techniques, including the ability to perform selective and superselective embolization, offer an attractive therapeutic alternative in the setting of active arterial extravasation associated with adrenal gland injury .
Notes & References
 Mehrazin R, Derweesh IH, Kincade MC, Thomas AC, Gold R, Wake RW. Adrenal trauma: Elvis Presley Memorial Trauma Center experience. Urology. 2007 Nov;70(5):851-855.
 Stawicki SP, Hoey BA, Grossman MD, Anderson HL 3rd, Reed JF 3rd. Adrenal gland trauma is associated with high injury severity and mortality. Curr Surg. 2003 Jul-Aug;60(4):431-436.
 Ikeda O, Urata J, Araki Y, Yoshimatsu S, Kume S, Torigoe Y, Yamashita Y. Acute adrenal hemorrhage after blunt trauma. Abdom Imaging. 2007;32:248-252.
 Scully RE, Mark EJ, McNeely BU. Hypertension and an adrenal mass after a vehicular accident. N Engl J Med. 1984;311:783-790.
 Wilms G, Marchal G, Baert A, et al. CT and ultrasound features of post-traumatic adrenal hemorrhage. J Comput Assist Tomogr. 1987;11:112-115.
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