Presentation
Motor bike accident.
Patient Data
CT Abdomen & Pelvis:
Findings:
The right adrenal gland is diffusely swollen with ill-defined margins. There is also surrounding peri-adrenal fat stranding that extends into the anterior right perinephric space. No traumatic injury to the adjacent right kidney, or the remainder of the upper abdominal solid organs.
No traumatic bowel injury identified. The appendix has a normal appearance. No free intraperitoneal fluid collections or gas.
No enlarged abdominal or pelvic lymph nodes. IDC in situ, with a small volume of intra-vesical gas. Urachal remnant noted.
No lumbar spine fracture.
Minor bruising over the right flank.
Conclusion:
Traumatic right adrenal gland hemorrhage.
Case Discussion
Isolated traumatic adrenal gland injuries are uncommon due to the position deep within the retroperitoneum. Thus upon detection of an adrenal gland injury, assessment for more subtle regional solid organ (eg. liver, spleen renal) or bowel injury is necessary.
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