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Review of the Clinical Characteristics of Adrenal Gland Injury Following Blunt Trauma in a Single Institution
단일 기관에서 경험한 둔기 손상에 따른 부신 손상의 임상적 특성 분석
J Acute Care Surg 2019;9:7−11
Published online April 30, 2019;  https://doi.org/10.17479/jacs.2019.9.1.7
© 2019 Korean Society of Acute Care Surgery.

Sung Yong Hong, M.D.*, Ki Hoon Kim, M.D., Ph.D.
홍성용*ㆍ김기훈

Departments of *Critical Care Medicine and Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
인제대학교 의과대학 해운대백병원 *중환자의학과, 외과학교실
Ki Hoon Kim, M.D., Ph.D.
Department of Surgery, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea
Tel: +82-51-797-0260
Fax: +82-51-797-0499
E-mail: medhun@hanmail.net
ORCID: https://orcid.org/0000-0003-2008-7572
Received July 24, 2018; Revised September 5, 2018; Accepted September 27, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Adrenal gland injuries in trauma are rare and usually misdiagnosed or underestimated in an emergency setting because they are asymptomatic and associated with severe abdominal injuries. This paper reviews the clinical characteristics of adrenal injuries.
Methods: A retrospective analysis of trauma patients who visited the authors’ emergency center was performed from March, 2010 to December, 2017. The patient demographic data, injury mechanism & associated injuries, injury severity score, hospital stay, and mortality were retrieved and analyzed.
Results: Adrenal gland injuries were found in 52 patients: 73.1% (n=38) were males and the mean age was 43.6 years. Of the patients, 84.6% (n=44) had ISS ≥15. Right adrenal gland injuries occurred in 82.7% (n=43). The mechanism of injury was falls in 30.8% (n=16), motor vehicle accidents in 25.0% (n=13), and pedestrian accidents in 23.1% (n=12). Associated injures were liver injury (58.5%), rib fracture (52.8%), kidney injury (24.5%), pelvic bone fracture (20.8%), spine fracture (28.3%), and spleen injury (13.2%). The mean hospital stay was 34.2 days, and the intensive care unit stay was 9 days. The mortality rate was 3.8% (n=2).
Conclusion: Adrenal gland injuries are common in males and frequent in the right side. Falls are the leading cause of injury. Most injuries have an associated injury at the abdominal or thoracic region. Adrenal injury is accompanied by high injury severity but showed a good prognosis.
Keywords : Adrenal gland injury, Trauma, Abdominal injury, Injury severity score


April 2019, 9 (1)
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