Traumatic and non-traumatic adrenal emergencies

Abstract

Multiple traumatic and non-traumatic adrenal emergencies are occasionally encountered during the cross-sectional imaging of emergency department patients. Traumatic adrenal hematomas are markers of severe polytrauma, and can be easily overlooked due to multiple concomitant injuries. Patients with non-traumatic adrenal emergencies usually present to an emergency department with a non-specific clinical picture. The detection and management of adrenal emergencies is based on cross-sectional imaging. Adrenal hemorrhage, adrenal infection, or rupture of adrenal neoplasm require immediate detection to avoid dire consequences. More often however, adrenal emergencies are detected incidentally in patients being investigated for non-specific acute abdominal pain. A high index of suspicion is required for the establishment of timely diagnosis and to avert potentially life-threatening complications. We describe cross-sectional imaging findings in patients with traumatic and non-traumatic adrenal hemorrhage, adrenal infarctions, adrenal infections, and complications of adrenal masses.

Interventional radiology of the adrenal glands: current status

“…The incidence of adrenal injury varies from 0.15% to 4% in various series (148). However, adrenal hemorrhage has been found in 13 of 50 (26%) autopsies of patients who died of severe blunt trauma to the chest or abdomen (149).…”

“…Signs and symptoms are non-specific, therefore adrenal hemorrhage in critically ill patients is typically discovered on a CT (148).…”

Abdominal Travma

“…US'de hiperekojen olarak izlenir. Kontrastsız BT'de, 50 HU'nun üzerinde dansitede, haftalar içerisinde boyutu gerileyen lezyon adrenal hemoraji lehinedir [1,26].…”

Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female

“…These properties make DWI a viable imaging tool since it can predict which organs or pathologic processes restrict molecules (like hemoglobin) within a certain tissue without the use of contrast media or radiation. An apparent diffusion coefficient (ADC) map is then created to verify if an area in question truly restricts diffusion, in order to reduce potential false positives on DWI images [1,2].…”

“…It is logical that these two risk factors together, hypercoagulability of pregnancy and adrenal vein anatomy, may exacerbate blood stasis within the adrenal vein and lead to venous thrombosis. The risk of a thrombosis and consequentially infarction should be considered in non-pregnant patients with a known hyper-coagulable state [2][3][4][5][6][7][8][9][10][11][12][13][14].…”