Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

MDCT Findings of Traumatic Adrenal Injury in Children

소아 외상성 부신 손상의 MDCT 소견

  • Choi, Seung-Joon (Department of Radiology, Gachon University, Gil Medical Center) ;
  • Kim, Jee-Eun (Department of Radiology, Gachon University, Gil Medical Center) ;
  • Ryu, Il (Department of Pediatrics, Gachon University, Gil Medical Center) ;
  • Kim, Jin-Joo (Department of Emergency Medicine, Gachon University, Gil Medical Center) ;
  • Choi, Hye-Young (Department of Radiology, Gachon University, Gil Medical Center)
  • 최승준 (가천의과대학교 길병원 영상의학과) ;
  • 김지은 (가천의과대학교 길병원 영상의학과) ;
  • 류일 (가천의과대학교 길병원 소아청소년과) ;
  • 김진주 (가천의과대학교 길병원 응급의학과) ;
  • 최혜영 (가천의과대학교 길병원 영상의학과)
  • Published : 2011.02.01
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Abstract

Purpose: We wanted to evaluate the MDCT findings and concomitant injuries of traumatic adrenal injury in children. Materials and Methods: Among 375 children who had undergone a MDCT scan for abdominal trauma during the recent five years at our institution, 27 children who had revealed adrenal injury on their CT scan were included in the study. We retrospectively evaluated the causes of the trauma, the patterns of adrenal injury, the associated CT findings and the concomitant injuries of the other organs in the abdomen. Results: We identified 27 children (7.5%) (17 boys and 10 girls, mean age: 9.9 years, range: 2-18 years) with adrenal injury. The causes of adrenal injury were a traffic accident for 20 patients (74%), falls for four patients (15%) and blunt trauma for three patients (11%). The right adrenal gland was injured in 20 patients (74%), while the left adrenal gland was injured in three patients and bilateral involvement was noted in four patients. The patterns of adrenal injury were round or oval shaped hematoma in 23 lesions (74%), irregular hemorrhage with obliterating the gland in six lesions (19%) and active extravasation of contrast material from the adrenal region in two lesions (7%). Concomitant injuries were noted in 22 patients (81%), including 15 patients with liver laceration (56%), 11 patients with lung contusion (41%) and nine patients with renal injury (33%). Conclusion: The frequency of adrenal injury was 7.5%. The right adrenal gland was more frequently involved. Concomitant organ injury was noted 81% of the patients and the most frequently involved organ was the liver (56%).

목적: 소아의 외상성 부신 손상의 MDCT 소견과 동반 손상에 대해 알아보고자 하였다. 대상과 방법: 최근 5년간 외상으로 MDCT를 시행한 357명의 소아 환자 중 부신 손상이 확인된 27명의 CT 소견을 후향적으로 분석하였다. 부신 손상의 원인, 부신 출혈의 형태와 관련 소견, 그리고 복강 내 다른 장기의 동반 손상을 분석하였다 결과: 부신 손상의 빈도는 7.5%였으며, 27명의 환아는 남아가 17명, 여아가 10명이었고 평균연령은 9.9세(2-18세)였다. 부신 손상의 원인은 교통사고 20명(74%), 추락 4명(15%), 둔상 3명(11%)의 순이었다. 우측 부신 손상은 20명(74%), 좌측 부신 손상은 3명, 그리고 4명에서 양측 부신 손상이 확인되었다. MDCT 소견은 둥글거나 타원형의 혈종으로 보이는 경우가 23예(74%), 불규칙한 모양을 갖는 경우가 6예(19%), 부신 주변으로 조영제의 혈관 밖 유출이 보이는 경우가 2예(7%)로 관찰되었다. 주변 장기 손상은 22명(81%)에서 동반되었고 간 열상 15명(56%), 폐 좌상 11명(41%), 그리고 신장 손상 9명(33%) 순으로 관찰되었다. 결론: 소아의 복부외상에서 부신 손상의 빈도는 7.5%였으며, 우측손상이 흔하였고(74%), 81%에서 주변 장기 손상이 동반되었으며 간 손상(56%)이 가장 흔하였다.

Keywords

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