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Pediatric Adrenal Trauma in the 21st Century: Children's Hospital of Atlanta Experience.
MedLine Citation:
PMID:  21575968     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Adrenal trauma in children is rare and poorly characterized. To characterize these injuries better, we reviewed the contemporary experience at a large pediatric trauma center. MATERIALS AND METHODS: We queried the trauma registry of Children's Hospitals of Atlanta for all patients treated for adrenal trauma (ICD-9 codes 868.01 and 868.11) between January 1, 2000 and December 31, 2009. We performed a detailed chart review. RESULTS: Of 12,045 patients who were treated for trauma during the study period 42 children (0.35%) with adrenal injuries were identified. All injuries resulted from blunt trauma. Motor vehicle crash was the most common mechanism, responsible for 41% of injuries. A total of 41 cases (98%) were diagnosed by computerized tomography and 1 during exploratory laparotomy for associated vascular injury. Injuries were to the right adrenal gland in 36 cases (86%), left in 5 (12%) and bilateral in 1 (2%). The most common associated regions were the liver (55%), head or brain (33%) and skeleton (31%). Five patients (12%) experienced isolated adrenal injuries. One patient required treatment for adrenal insufficiency and none required adrenalectomy, adrenalorrhaphy or adrenal embolization. Of patients with isolated adrenal injuries 2 were hospitalized and 3 were treated as outpatients. All had an unremarkable course. CONCLUSIONS: Adrenal trauma in children is rare. Although typically associated with high morbidity, this outcome is likely from related injuries as an isolated adrenal injury generally portends a benign course.
Authors:
Bradley D Figler; Rachel Webman; Christina Ramey; Jonathan Kaye; Ellen Patrick; Andrew Kirsch; Edwin Smith; Viraj A Master
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-14
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Atlanta, Georgia.
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