Isolated Right Adrenal Hemorrhage in a Pediatric Pedestrian–Vehicle Collision: A Rare Injury Pattern and Review of Mechanisms
Maria Mirasol Paulino, MD1, Samuel Hale, MD1, Brian Francis Gilchrist, MD1*, Nelson Menezes, MD1, Christopher Judge Lighfoot, MD1
1The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
*Corresponding Author: Brian Francis Gilchrist, MD, Chief, Pediatric Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.
https://doi.org/10.58624/SVOAPD.2026.05.019
Received: April 23, 2026
Published: June 26, 2026
Citation: Paulino MM, Hale S, Gilchrist BF, Menezes N, Lighfoot CJ. Isolated Right Adrenal Hemorrhage in a Pediatric Pedestrian–Vehicle Collision: A Rare Injury Pattern and Review of Mechanisms. SVOA Paediatrics 2026, 5:3, 131-135. doi: 10.58624/SVOAPD.2026.05.019
Abstract
Isolated adrenal trauma in the pediatric population is rare due to the gland’s deep retroperitoneal location and surrounding protective structures. We present a case of a 17-year-old male who sustained an isolated right adrenal hemorrhage following a high-energy pedestrian–vehicle collision. Despite a significant mechanism of injury, the patient remained hemodynamically stable, and diagnosis was established with contrast-enhanced computed tomography (CT) after a negative Focused Assessment with Sonography for Trauma (FAST) examination. This case highlights the unique vulnerability of the right adrenal gland, limitations of ultrasound in detecting retroperitoneal injuries, and the importance of maintaining a high index of suspicion. The pathophysiology of adrenal injury is multifactorial, involving venous hypertension, compressive forces, and vascular shearing. Conservative management remains the standard of care in stable patients, with excellent outcomes.
Keywords: Pediatric Trauma, Adrenal Hemorrhage, Blunt Abdominal Trauma, Retroperitoneal Injury, Isolated Adrenal Injury