Background
Blunt adrenal gland trauma (BAGT) is a potentially devastating event if unrecognized
during the treatment course of patients with trauma. Because of its rarity, no current
algorithm or consensus exists for BAGT. In the present study, we demonstrated the
feasibility and safety of transcatheter angiographic embolization (TAE) in BAGT and
analyzed the clinical presentation and outcome of BAGT.
Methods
We conducted a prospective collection and retrospective review at a level I trauma
center in Taiwan. This study included all of the patients that sustained BAGT from
May 2004 to May 2013. We retrieved and analyzed the patient demographic data, clinical
presentation, BAGT grade, injury severity score, management, hospital stay, and mortality.
Results
The cohort consisted of 77 patients: 59 men and 18 women. The mean age was 34.3 ± 15.5 years.
The right side was the predominant site of injury (59/77; 76.6%). Six patients underwent
operation; 18 patients underwent angiography, including four TAEs, and the remaining
patients underwent conservative management. The mortality rate was 9.1% (7/77), and
a high injury severity score was an independent factor to predict mortality.
Conclusion
In conclusion, BAGT is a rare injury with a benign prognosis. Most patients can be
treated conservatively. Furthermore, this study demonstrates that both TAE and operation
can be used to achieve hemostasis. The mortality of BAGT was related to severe associated
injuries. BAGT is an indicator of severe multiple trauma; however, it does not increase
mortality or prolong hospital stay.
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Article info
Publication history
Accepted:
September 3,
2014
Footnotes
Chien-Hung Liao and Chun-Hsiang Ouyang both contributed equally to this work.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
