Case contribution: Dr Radhiana Hassan
Clinical:
- A 21 years old man
- Involved in MVA; motorcyclist hit by a car
- On arrival vital signs were stable and patient was fully conscious
- Patient complaint of right abdominal pain.
CT scan findings:
- Multiple short lacerations within the liver in the right lobe (red arrows)
- Right adrenal gland is diffusely enlarged with streakiness of surrounding fat and indinstinct border or outline (yellow arrow)
- Associated minimal fluid at hepatorenal fossa
- No other organ injury
- Also noted to have right pneumothorax (white arrow) and multiple contusions (blue arrows)
- No rib fracture is seen.
Progress of patient:
- Patient was managed conservatively
- Discharged well few days after.
Diagnosis: Grade II liver injury with right adrenal injury
Discussion:
- Adrenal gland trauma is present on 1-2% of CT imaging in blunt trauma.
- The right adrenal gland is more commonly affected than the left.
- Isolated adrenal gland trauma is uncommon;<5% of all adrenal trauma.
- Associated injuries include lung injuries, liver, spleen and/or renal injuries, rib, pelvic or spine injuries and head injury
- CT appearance include mass-like hematoma, diffuse enlargement of the gland, splaying of adrenal limbs and surrounding fat stranding
