Pediatric Adrenal Trauma

  • Etiology: Blunt abdominal trauma causing direct compression or shearing of perforating vessels or rapid rise in intraabdominal venous pressure
  • Imaging:
    — Usually on right side and usually unilateral
    — Often associated with ipsilateral visceral injury
  • Note: Isolated adrenal hemorrhage after blunt trauma is rare so when present look for injury to adjacent structures like liver or spleen or ribs or kidneys
  • DDX:
  • Complications:
  • Treatment: None
  • Clinical: Can occur in the setting of child abuse

Radiology Cases of Adrenal Trauma

Radiology Cases of Incorrect CT Technique Without the Use of Intravenous Contrast for the Assessment of Blunt Abdominal Trauma

CT without intravenous contrast using incorrect technique for the assessment of blunt abdominal trauma
Axial CT without contrast of the abdomen shows grossly unremarkable unenhanced solid organs of the abdomen without free air or free fluid.

Radiology Cases of Adrenal Trauma

CT of adrenal hemorrhage
Axial CT with contrast of the abdomen show a low density fluid collection in the right adrenal gland and low density in the posterior aspect of the right kidney.

Radiology Cases of Adrenal Hemorrhage and Liver Trauma

CT of liver laceration and adrenal hemorrhage
AXR AP (above) obtained after an outside upper GI exam which demonstrated normal bowel rotation shows contrast filling multiple dilated loops of small bowel. Initial AP image from an enema (below left) shows a microcolon with contrast almost reaching the cecum. Later image from the enema (below right) shows reflux of contrast into dilated loops of distal ileum in the right lower quadrant.
CT of adrenal trauma / adrenal laceration and liver trauma / liver laceration
Axial CT with contrast of the abdomen shows a large amount of fluid in the region of the right adrenal gland and areas of low density in the middle and posterior aspects of the right lobe of the liver.
CT of liver laceration
Axial CT with contrast of the abdomen shows two low density poorly circumscribed lesions in the right lobe of the liver.