Adrenal gland trauma is a rare and scarcely reported injury due to its retroperitoneal position and relationship with adjacent tissues. We report a male patient with a history of a thoracoabdominal blunt trauma with adrenal injury as an isolated abdominal viscera. He was hemodynamically stable at admission, with a blush within his adrenal hematoma. The patient was treated nonoperatively and subsequently discharged after 15 days. The available literature reports advantages of a nonoperative approach compared to surgery, which is necessary in only 1% of cases that are predominantly polytrauma patients with multiple intra-abdominal injuries. Therefore, a nonoperative treatment is recommended for patients with an isolated adrenal gland injury who are hemodynamically stable during hospital stay.
Objective: Cervical trauma is an important cause of morbidity and mortality, affecting 2% of patients admitted to emergency units. Therefore, this study aims to compare the use of two clinical cervical spine evaluation algorithms, the Canadian C-Spine Rule (CCR) and the National Emergency X-radiography Utilization Study (NEXUS). Methods: A descriptive study of the use of the two algorithms by medical residents in the initial assessment of severely traumatized patients admitted to the regional emergency unit was conducted. The evaluation of the indication for imaging tests and the positive predictive value of the algorithms were the parameters analyzed. Finally, the residents answered a questionnaire evaluating the applicability, degree of confidence and advantages of both flowcharts. Results: There was no significant difference between the number of indications for imaging or their predictive values. In the analysis of the questionnaires, the CCR proved to be more reliable and the NEXUS more applicable, and the positive and negative points of applying each of them were highlighted. Conclusion: It is concluded that the two methods are similar in detecting injuries and optimizing the use of imaging exams, being equally indicated to evaluate cervical trauma. However, the technical specifics of each must be taken into account when deciding which to use. Level of evidence IV; Descriptive Study.
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