Abstract
Background Blunt adrenal gland trauma (BAGT) is a potentially devastating event if unrecognized during the treatment course of patients with trauma. Because of its rarity, no current algorithm or consensus exists for BAGT. In the present study, we demonstrated the feasibility and safety of transcatheter angiographic embolization (TAE) in BAGT and analyzed the clinical presentation and outcome of BAGT. Methods We conducted a prospective collection and retrospective review at a level I trauma center in Taiwan. This study included all of the patients that sustained BAGT from May 2004 to May 2013. We retrieved and analyzed the patient demographic data, clinical presentation, BAGT grade, injury severity score, management, hospital stay, and mortality. Results The cohort consisted of 77 patients: 59 men and 18 women. The mean age was 34.3 ± 15.5 years. The right side was the predominant site of injury (59/77; 76.6%). Six patients underwent operation; 18 patients underwent angiography, including four TAEs, and the remaining patients underwent conservative management. The mortality rate was 9.1% (7/77), and a high injury severity score was an independent factor to predict mortality. Conclusion In conclusion, BAGT is a rare injury with a benign prognosis. Most patients can be treated conservatively. Furthermore, this study demonstrates that both TAE and operation can be used to achieve hemostasis. The mortality of BAGT was related to severe associated injuries. BAGT is an indicator of severe multiple trauma; however, it does not increase mortality or prolong hospital stay.
| Original language | English |
|---|---|
| Pages (from-to) | 338-343 |
| Number of pages | 6 |
| Journal | Surgery (United States) |
| Volume | 157 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 1 2015 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
Cite this
The current status and management of blunt adrenal gland trauma. / Liao, Chien Hung; Ouyang, Chun Hsiang; Fu, Chih Yuan; Wang, Shang Yu; Lin, Kuo Jen; Kuo, I. Ming; Hsu, Chih Po; Yang, Shang Ju; Yuan, Kuo Chin; Hsu, Yu Pao.
In: Surgery (United States), Vol. 157, No. 2, 01.02.2015, p. 338-343.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The current status and management of blunt adrenal gland trauma
AU - Liao, Chien Hung
AU - Ouyang, Chun Hsiang
AU - Fu, Chih Yuan
AU - Wang, Shang Yu
AU - Lin, Kuo Jen
AU - Kuo, I. Ming
AU - Hsu, Chih Po
AU - Yang, Shang Ju
AU - Yuan, Kuo Chin
AU - Hsu, Yu Pao
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background Blunt adrenal gland trauma (BAGT) is a potentially devastating event if unrecognized during the treatment course of patients with trauma. Because of its rarity, no current algorithm or consensus exists for BAGT. In the present study, we demonstrated the feasibility and safety of transcatheter angiographic embolization (TAE) in BAGT and analyzed the clinical presentation and outcome of BAGT. Methods We conducted a prospective collection and retrospective review at a level I trauma center in Taiwan. This study included all of the patients that sustained BAGT from May 2004 to May 2013. We retrieved and analyzed the patient demographic data, clinical presentation, BAGT grade, injury severity score, management, hospital stay, and mortality. Results The cohort consisted of 77 patients: 59 men and 18 women. The mean age was 34.3 ± 15.5 years. The right side was the predominant site of injury (59/77; 76.6%). Six patients underwent operation; 18 patients underwent angiography, including four TAEs, and the remaining patients underwent conservative management. The mortality rate was 9.1% (7/77), and a high injury severity score was an independent factor to predict mortality. Conclusion In conclusion, BAGT is a rare injury with a benign prognosis. Most patients can be treated conservatively. Furthermore, this study demonstrates that both TAE and operation can be used to achieve hemostasis. The mortality of BAGT was related to severe associated injuries. BAGT is an indicator of severe multiple trauma; however, it does not increase mortality or prolong hospital stay.
AB - Background Blunt adrenal gland trauma (BAGT) is a potentially devastating event if unrecognized during the treatment course of patients with trauma. Because of its rarity, no current algorithm or consensus exists for BAGT. In the present study, we demonstrated the feasibility and safety of transcatheter angiographic embolization (TAE) in BAGT and analyzed the clinical presentation and outcome of BAGT. Methods We conducted a prospective collection and retrospective review at a level I trauma center in Taiwan. This study included all of the patients that sustained BAGT from May 2004 to May 2013. We retrieved and analyzed the patient demographic data, clinical presentation, BAGT grade, injury severity score, management, hospital stay, and mortality. Results The cohort consisted of 77 patients: 59 men and 18 women. The mean age was 34.3 ± 15.5 years. The right side was the predominant site of injury (59/77; 76.6%). Six patients underwent operation; 18 patients underwent angiography, including four TAEs, and the remaining patients underwent conservative management. The mortality rate was 9.1% (7/77), and a high injury severity score was an independent factor to predict mortality. Conclusion In conclusion, BAGT is a rare injury with a benign prognosis. Most patients can be treated conservatively. Furthermore, this study demonstrates that both TAE and operation can be used to achieve hemostasis. The mortality of BAGT was related to severe associated injuries. BAGT is an indicator of severe multiple trauma; however, it does not increase mortality or prolong hospital stay.
UR - http://www.scopus.com/inward/record.url?scp=84921364364&partnerID=8YFLogxK
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U2 - 10.1016/j.surg.2014.09.001
DO - 10.1016/j.surg.2014.09.001
M3 - Article
VL - 157
SP - 338
EP - 343
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 2
ER -