Jegadeesan Madhusudhanan, Robert A John, Sekar Thodana Vadivelu
Department of Surgical Gastroenterology, Apollo Speciality Hospitals, Madurai, Tamil Nadu, India.
Department of Interventional Radiology, Apollo Speciality Hospitals, Madurai, Tamil Nadu, India.
Indian J Urol. 2020 Jan-Mar;36(1):59-61. doi: 10.4103/iju.IJU_166_19.
Blunt adrenal gland trauma is an uncommon injury owing to the location of the adrenal gland in the retroperitoneum surrounded by major viscera and bony structures. We present a case of a 23-year-old male, who had sustained multiple injuries following a road traffic accident. Computed tomography scan revealed a large retroperitoneal hematoma, and active contrast extravasation was noted in the retroperitoneum adjacent to the bare area of the liver and right adrenal gland. After a trial of initial conservative management, he had expanding retroperitoneal hematoma with dropping hemoglobin. Angiography showed posttraumatic aneurysm from the adrenal artery that was successfully embolized with microcoils. As blunt adrenal gland trauma is rare, a high degree of clinical suspicion is required for the diagnosis, and multidisciplinary discussion is essential for the successful management of adrenal gland trauma.
钝性肾上腺损伤并不常见，因为肾上腺位于腹膜后，周围环绕着主要脏器和骨性结构。我们报告一例23岁男性病例，该患者在道路交通事故后受到多处损伤。计算机断层扫描显示腹膜后有巨大血肿，在肝脏裸区和右肾上腺附近的腹膜后可见造影剂外渗。经过初步保守治疗后，他的腹膜后血肿仍在扩大，血红蛋白水平下降。血管造影显示肾上腺动脉创伤性动脉瘤，用微线圈成功栓塞。由于钝性肾上腺损伤罕见，诊断时需要高度的临床怀疑，多学科讨论对于肾上腺损伤的成功治疗至关重要。
