Adrenal lesions in patients with abdominal multitrauma.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-06-21 DOI:10.1007/s12020-025-04321-9

Anna Kistner, Lisa Kekonius, Jan Calissendorf, Seppo Koskinen, Henrik Falhammar

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引用次数: 0

Abstract

Purpose: Most adrenal lesions are less than 2 cm and can easily be ignored during primary review of computed tomography (CT)-scans with another question. Furthermore, adrenal lesions, including adrenal hematomas, can easily be missed in patients with multitrauma. We aimed to determine the incidence of adrenal lesions in patients with multitrauma.

Methods: This retrospective, single-center cohort analysis included 1373 patients with multitrauma (71.2% males) with a mean age of 42 (95%CI 41-43) years. One radiologist re-examined all multitrauma CT performed 2013-2017 using thin sliced imaging in at least two depictions. A second radiologist re-examined patients where an abnormality was found. Adrenal abnormalities were labelled adrenal lesions (size ≥10 mm) or hematomas, respectively. Clinical data were collected.

Results: The adrenal lesion prevalence was 2.7% (37/1373, 78% males, 22% bilateral). Of these 27% (10/37) were mentioned in the radiological report, and in those with a size ≥15 mm (n = 13), 38% (5/13) were mentioned. Of the unilateral adrenal lesions 86% (25/29) were left-sided. In the adrenal lesion group during the mean follow-up time of 75 (61-90) months none had surgery, 6% had hormones measured (all normal), and 7% had repeated adrenal imaging. The adrenal hematoma prevalence was 5.0% (68/1373, 10% bilateral). No patient had both an adrenal hematoma and an adrenal lesion. Of the unilateral hematomas 42% (26/62) were not mentioned. Of the hematomas 77% were right-sided. No patient with adrenal abnormalities had signs of adrenal insufficiency. 30-day survival rates in the adrenal lesion and hematomas groups were similar, but the hematoma group had higher injury severity score, but no longer length of hospital stay.

Conclusions: The prevalence of adrenal tumors was 2.7% and adrenal hematomas 5.0%. Most lesions were not mentioned in the image report. Few had hormonal evaluation or adrenal imaging follow-up. Survival rates were similar between the two groups.

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腹部多重创伤患者的肾上腺损伤。

目的：大多数肾上腺病变小于2厘米，在计算机断层扫描（CT）的初步检查中很容易被忽视。此外，肾上腺损伤，包括肾上腺血肿，很容易在多重创伤患者中被遗漏。我们的目的是确定多重创伤患者肾上腺损伤的发生率。方法：该回顾性单中心队列分析纳入1373例多重创伤患者（71.2%为男性），平均年龄42岁（95%CI 41-43）。一位放射科医生重新检查了2013-2017年进行的所有多创伤CT，使用至少两种薄片成像。另一位放射科医生重新检查了发现异常的病人。肾上腺异常分别标记为肾上腺病变（≥10 mm）或血肿。收集临床资料。结果：肾上腺病变患病率为2.7%(37/1373)，其中男性78%，双侧22%。其中27%（10/37）在放射学报告中被提及，而在≥15mm （n = 13）的患者中，有38%（5/13）被提及。单侧肾上腺病变86%（25/29）位于左侧。肾上腺病变组平均随访75（61-90）个月，无手术，6%激素测量（均正常），7%反复肾上腺造影。肾上腺血肿患病率为5.0%（68/1373，双侧10%）。没有患者同时出现肾上腺血肿和肾上腺病变。单侧血肿42%（26/62）未被提及。77%的血肿位于右侧。没有肾上腺异常的患者有肾上腺功能不全的迹象。肾上腺损伤组和血肿组的30天生存率相似，但血肿组损伤严重程度评分较高，但住院时间不长。结论：肾上腺肿瘤患病率为2.7%，肾上腺血肿患病率为5.0%。大多数病变在图像报告中未被提及。很少有激素评估或肾上腺影像学随访。两组患者的存活率相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.