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• W2020980564 abstract "No AccessJournal of UrologyPediatric Urology1 Jul 2011Pediatric Adrenal Trauma in the 21st Century: Children's Hospital of Atlanta Experience Bradley D. Figler, Rachel Webman, Christina Ramey, Jonathan Kaye, Ellen Patrick, Andrew Kirsch, Edwin Smith, and Viraj A. Master Bradley D. FiglerBradley D. Figler Department of Urology, Emory University School of Medicine, Atlanta, Georgia More articles by this author , Rachel WebmanRachel Webman Emory University School of Medicine, Atlanta, Georgia More articles by this author , Christina RameyChristina Ramey Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author , Jonathan KayeJonathan Kaye Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author , Ellen PatrickEllen Patrick Department of Radiology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author , Andrew KirschAndrew Kirsch Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author , Edwin SmithEdwin Smith Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author , and Viraj A. MasterViraj A. Master Department of Urology, Emory University School of Medicine, Atlanta, Georgia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.03.047AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Adrenal trauma in children is rare and poorly characterized. To characterize these injuries better, we reviewed the contemporary experience at a large pediatric trauma center. Materials and Methods: We queried the trauma registry of Children's Hospitals of Atlanta for all patients treated for adrenal trauma (ICD-9 codes 868.01 and 868.11) between January 1, 2000 and December 31, 2009. We performed a detailed chart review. Results: Of 12,045 patients who were treated for trauma during the study period 42 children (0.35%) with adrenal injuries were identified. All injuries resulted from blunt trauma. Motor vehicle crash was the most common mechanism, responsible for 41% of injuries. A total of 41 cases (98%) were diagnosed by computerized tomography and 1 during exploratory laparotomy for associated vascular injury. Injuries were to the right adrenal gland in 36 cases (86%), left in 5 (12%) and bilateral in 1 (2%). The most common associated regions were the liver (55%), head or brain (33%) and skeleton (31%). Five patients (12%) experienced isolated adrenal injuries. One patient required treatment for adrenal insufficiency and none required adrenalectomy, adrenalorrhaphy or adrenal embolization. Of patients with isolated adrenal injuries 2 were hospitalized and 3 were treated as outpatients. All had an unremarkable course. Conclusions: Adrenal trauma in children is rare. Although typically associated with high morbidity, this outcome is likely from related injuries as an isolated adrenal injury generally portends a benign course. References 1 : Adrenal gland trauma: diagnosis and management. J Trauma1993; 35: 870. Google Scholar 2 : Adrenal trauma: Elvis Presley Memorial Trauma Center experience. Urology2007; 70: 851. Google Scholar 3 : Adrenal gland trauma is associated with high injury severity and mortality. Curr Surg2003; 60: 431. Google Scholar 4 : Adrenal lacerations in child abuse: a marker of severe trauma. Pediatr Surg Int2000; 16: 121. Google Scholar 5 : Traumatic adrenal hemorrhage in children: an indicator of visceral injury. Pediatr Surg Int2000; 16: 586. Google Scholar 6 : Posttraumatic adrenal hemorrhage in children: CT findings in 34 patients. AJR Am J Roentgenol1992; 158: 1299. Google Scholar 7 : Emergency department evaluation and management of blunt abdominal trauma in children. Curr Opin Pediatr2007; 19: 265. Google Scholar 8 : Increasing utilization of computed tomography in the pediatric emergency department, 2000–2006. Emerg Radiol2007; 14: 227. Google Scholar 9 : Embolization of traumatic adrenal hemorrhage. J Trauma1999; 47: 1153. Google Scholar 10 : Bilateral post-traumatic adrenal hemorrhage: Report of a case with acute adrenal insufficiency . Ann Chir2000; 125: 273. Google Scholar 11 : Recovery of adrenal function after failure resulting from traumatic bilateral adrenal hemorrhages. Ann Intern Med1991; 115: 785. Google Scholar 12 : Acute bilateral adrenal hemorrhage secondary to rough truck ride. J Emerg Med1996; 14: 15. Google Scholar 13 : Bilateral adrenal hemorrhage in blunt abdominal trauma. J Trauma2000; 48: 332. Google Scholar 14 : Transient adrenocortical insufficiency following traumatic bilateral adrenal hemorrhage. J Trauma2004; 56: 1135. Google Scholar 15 : The adrenal cortex. In: Endocrine Pathology: General and Surgical. Edited by . Baltimore: Williams and Wilkins1982: 419. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 186Issue 1July 2011Page: 248-251 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsadrenal glandswounds and injurieschild abusetrauma severity indicesaccidentstrafficMetricsAuthor Information Bradley D. Figler Department of Urology, Emory University School of Medicine, Atlanta, Georgia More articles by this author Rachel Webman Emory University School of Medicine, Atlanta, Georgia More articles by this author Christina Ramey Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author Jonathan Kaye Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author Ellen Patrick Department of Radiology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author Andrew Kirsch Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author Edwin Smith Department of Urology, Emory University School of Medicine, Atlanta, Georgia Department of Urology, Children's Hospitals of Atlanta, Atlanta, Georgia More articles by this author Viraj A. Master Department of Urology, Emory University School of Medicine, Atlanta, Georgia More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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