Presentation
Motor vehicle collision >100 km/hr; persistent tachycardia.
Patient Data
Soft tissue density (mean HU = 48) lesion of the right adrenal gland measures 3.7 cm (ap) X 2.2 cm (trans) X 3.5cm (craniocaudally). It is associated with some ill-defined perinephric opacity at the upper pole of the right kidney.
Liver, gallbladder, spleen and pancreas are of unremarkable appearance. Left adrenal gland unremarkable. Simple renal cysts.
No pneumoperitoneum. No free fluid.
Acute fractures of the right L1-L3 transverse processes, minimally displaced.
Conclusions:
Right adrenal lesion, in the setting of trauma probably represents a hematoma. Comparison with any prior imaging required or if not available follow-up CT recommended.
Case Discussion
Follow-up CT three months later demonstrated a normal right adrenal gland, confirming this lesion as a traumatic hematoma.
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