Successful angioembolization for blunt adrenal gland trauma

Abstract

Blunt adrenal gland trauma is an uncommon injury owing to the location of the adrenal gland in the retroperitoneum surrounded by major viscera and bony structures. We present a case of a 23-year-old male, who had sustained multiple injuries following a road traffic accident. Computed tomography scan revealed a large retroperitoneal hematoma, and active contrast extravasation was noted in the retroperitoneum adjacent to the bare area of the liver and right adrenal gland. After a trial of initial conservative management, he had expanding retroperitoneal hematoma with dropping hemoglobin. Angiography showed posttraumatic aneurysm from the adrenal artery that was successfully embolized with microcoils. As blunt adrenal gland trauma is rare, a high degree of clinical suspicion is required for the diagnosis, and multidisciplinary discussion is essential for the successful management of adrenal gland trauma.