Traumatic adrenal haemorrhage in children
ABSTRACT Adrenal injuries following blunt abdominal trauma is uncommon. Recent increased detection of traumatic adrenal haemorrhage (TAH) prompted this study.
Cases were identified from retrospective search of the trauma and medical imaging database for the period 1998-2004. Medical records were reviewed and data analysed to identify mechanism of injury, imaging findings, associated injuries, presence of hypotension, length of stay and follow up.
Eleven children were identified with TAH. Right adrenal was commonly injured. Motor vehicle injury was the commonest mechanism. All injuries were identified on initial computed tomography, and all but one had associated abdominal injuries. There were no deaths. Ultrasound showed resolution within 3 months in six patients.
TAH is an uncommon injury that is rarely isolated. Although initial diagnosis is made on computed tomography, ultrasound appears adequate for follow up. TAH appears to be an incidental finding that resolves on follow-up imaging.
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ABSTRACT: Das Abdominaltrauma stellt nach wie vor eine Herausforderung im klinischen Alltag dar. Es erfordert ein strukturiertes Management mit dem Ziel einer raschen Diagnostik und Therapie zur Senkung der Morbidität und Letalität. Insbesondere die Verletzung der parenchymatösen Organe bestimmt die Prognose und den Verlauf des Patienten. Bei Leber- und Milzverletzungen besteht die primäre Herausforderung in der Beherrschung vital bedrohlicher Blutungen, bei Pankreasverletzungen müssen insbesondere septische Komplikationen vermieden werden. Hierbei gilt es, die chirurgische Therapie dem Verletzungsmuster sowie der Allgemeinsituation des Patienten anzupassen.Trauma und Berufskrankheit 01/2007; 9. DOI:10.1007/s10039-006-1205-0
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ABSTRACT: A retrospective review of the literature was performed to determine the natural history, prevalence, prognosis and management of adrenal injury associated with blunt abdominal trauma in pediatric population. Blunt adrenal injury in children is uncommon, rarely isolated, and typically present as part of a multi organ trauma. Adrenal hemorrhage is being diagnosed more frequently since the emergence of computed tomography in modern emergency rooms. Obstetric birth trauma during vaginal delivery of a macrosomic fetus may result in neonatal adrenal hemorrhage. In children appear to be an incidental finding that resolves on follow-up imaging. Most of these injuries are self-limited and do not require intervention. The differential diagnosis of an adrenal neoplasm, especially in children with an isolated adrenal hemorrhage, must be considered. The presence of adrenal hemorrhage in the absence of a trauma history should alert to the possibility of pediatric inflicted injury.Asian Journal of Surgery 07/2011; 34(3):103-10. DOI:10.1016/j.asjsur.2011.08.003 · 0.76 Impact Factor