Anna Kistner, Lisa Kekonius, Jan Calissendorf, Seppo Koskinen, Henrik Falhammar
{"title":"腹部多重创伤患者的肾上腺损伤。","authors":"Anna Kistner, Lisa Kekonius, Jan Calissendorf, Seppo Koskinen, Henrik Falhammar","doi":"10.1007/s12020-025-04321-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adrenal lesions in patients with abdominal multitrauma.\",\"authors\":\"Anna Kistner, Lisa Kekonius, Jan Calissendorf, Seppo Koskinen, Henrik Falhammar\",\"doi\":\"10.1007/s12020-025-04321-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":49211,\"journal\":{\"name\":\"Endocrine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12020-025-04321-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-025-04321-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Adrenal lesions in patients with abdominal multitrauma.
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.
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.
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