Adrenal gland trauma: Is extravasation an absolute indication for intervention?

Chien Hung Liao, Kuo Jen Lin, Chih Yuan Fu*, Shang Yu Wang, Shang Ju Yang, Chun Hsiang Ouyang

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

15 引文 斯高帕斯(Scopus)

摘要

Background: Adrenal gland trauma (AGT) is potentially devastating if unrecognized during the treatment of trauma patients. Because of the adrenal glands' rich vascularity, they often hemorrhage upon traumatic impact. However, there has been no conclusion about the indications for intervention in cases of hemorrhage after AGT. Methods: We conducted a prospective collection with a retrospective review in a Level I trauma center in Taiwan. This study enrolled all of the patients who suffered from AGT from May 2008 to May 2013. We retrieved and analyzed the patient demographic data, clinical presentation, AGT grade, injury severity score, management, hospital stay, and mortality. Results: The cohort consisted of 60 patients. The mean age was 31.0 ± 15.9 years. There were 32 patients (53.3 %) with extravasated AGT, which was associated with a high injury severity score, a high possibility of associated lung injury, and more than one accompanying trauma. Most of the patients could be treated conservatively. Five of these patients needed surgical hemostasis, and four of them needed angiographic embolization. Extravasation combined with a mean arterial pressure <70 mmHg was a predictor of the need for intervention (relative risk: 9.52, 95 % CI 1.64-55.56, p = 0.011). Conclusion: In conclusion, AGT is a rare injury with a good prognosis. Most AGT patients can be treated conservatively. Extravasation in AGT is not only a sign of hemorrhage, but also an indicator of severe associated injuries. However, extravasation in AGT does not always require further treatment. When intractable hypotension simultaneously occurs, further treatment should be considered.

原文英語
頁(從 - 到)1312-1319
頁數8
期刊World Journal of Surgery
39
發行號5
DOIs
出版狀態已出版 - 01 05 2015

文獻附註

Publisher Copyright:
© 2015 Société Internationale de Chirurgie.

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