The current status and management of blunt adrenal gland trauma

Chien Hung Liao, Chun Hsiang Ouyang, Chih Yuan Fu, Shang Yu Wang, Kuo Jen Lin, I. Ming Kuo, Chih Po Hsu, Shang Ju Yang, Kuo Chin Yuan, Yu Pao Hsu

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish
Pages (from-to)338-343
Number of pages6
JournalSurgery (United States)
Volume157
Issue number2
DOIs
Publication statusPublished - Feb 1 2015
Externally publishedYes

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Adrenal Glands
Wounds and Injuries
Injury Severity Score
Mortality
Length of Stay
Multiple Trauma
Trauma Centers
Hospital Mortality
Hemostasis
Taiwan
Angiography
Demography

ASJC Scopus subject areas

  • Surgery

Cite this

Liao, C. H., Ouyang, C. H., Fu, C. Y., Wang, S. Y., Lin, K. J., Kuo, I. M., ... Hsu, Y. P. (2015). The current status and management of blunt adrenal gland trauma. Surgery (United States), 157(2), 338-343. https://doi.org/10.1016/j.surg.2014.09.001

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 journalArticle

Liao, CH, Ouyang, CH, Fu, CY, Wang, SY, Lin, KJ, Kuo, IM, Hsu, CP, Yang, SJ, Yuan, KC & Hsu, YP 2015, 'The current status and management of blunt adrenal gland trauma', Surgery (United States), vol. 157, no. 2, pp. 338-343. https://doi.org/10.1016/j.surg.2014.09.001
Liao CH, Ouyang CH, Fu CY, Wang SY, Lin KJ, Kuo IM et al. The current status and management of blunt adrenal gland trauma. Surgery (United States). 2015 Feb 1;157(2):338-343. https://doi.org/10.1016/j.surg.2014.09.001
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. / The current status and management of blunt adrenal gland trauma. In: Surgery (United States). 2015 ; Vol. 157, No. 2. pp. 338-343.
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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.",
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AU - Kuo, I. Ming

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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.

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