Traumatic adrenal hemorrhage

Traumatic adrenal injury is rare, occurring in an estimated 0.15-2.4% of adult and pediatric trauma patients. This chapter offers practical guidance to the best practices in diagnosis, treatment and management of patients with traumatic adrenal hemorrhage. There is no clinical indication for adrenal imaging in the setting of blunt or penetrating trauma. As a result, adrenal injury is often discovered incidentally on CT imaging following trauma. The complications and deaths of patients with traumatic adrenal hemorrhage are largely due to concomitant injuries rather than from the adrenal trauma itself. Thus, the initial management of patients with traumatic adrenal injury is directed at controlling associated injuries such as liver laceration, pulmonary contusion, and renal trauma. Long-term sequelae of adrenal trauma are minimal. All reported cases of primary adrenalin sufficiency following traumatic injury requiring corticosteroid therapy were recoverable without need for long-term medical management.