Adrenal Trauma: Elvis Presley Memorial Trauma Center Experience

Reza Mehrazin, Ithaar H. Derweesh, Matthew C. Kincade, Adam C. Thomas, Robert Gold, Robert Wake

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: 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.

Original languageEnglish (US)
Pages (from-to)851-855
Number of pages5
JournalUrology
Volume70
Issue number5
DOIs
StatePublished - Nov 1 2007

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Trauma Centers
Wounds and Injuries
Adrenal Glands
Lacerations
Adrenalectomy
Urinary Tract Infections
Venous Thrombosis
Laparotomy
Pneumonia

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Adrenal Trauma : Elvis Presley Memorial Trauma Center Experience. / Mehrazin, Reza; Derweesh, Ithaar H.; Kincade, Matthew C.; Thomas, Adam C.; Gold, Robert; Wake, Robert.

In: Urology, Vol. 70, No. 5, 01.11.2007, p. 851-855.

Research output: Contribution to journalArticle

Mehrazin, R, Derweesh, IH, Kincade, MC, Thomas, AC, Gold, R & Wake, R 2007, 'Adrenal Trauma: Elvis Presley Memorial Trauma Center Experience', Urology, vol. 70, no. 5, pp. 851-855. https://doi.org/10.1016/j.urology.2007.07.004
Mehrazin, Reza ; Derweesh, Ithaar H. ; Kincade, Matthew C. ; Thomas, Adam C. ; Gold, Robert ; Wake, Robert. / Adrenal Trauma : Elvis Presley Memorial Trauma Center Experience. In: Urology. 2007 ; Vol. 70, No. 5. pp. 851-855.
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abstract = "Objectives: 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.",
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