Intense contrast enhancement of the adrenal glands: Another abdominal CT finding associated with hypoperfusion complex in children

OBJECTIVE. A constellation of CT findings has been associated with posttraumatic shock in children. Findings include fluid-filled, dilated bowel; intense enhancement of bowel wall, mesentery, pancreas, kidneys, aorta, and inferior vena cava; and small caliber of aorta and inferior vena cava. The objective of this study is to describe an additional CT finding in the hypoperfusion complex: symmetric, intense contrast enhancement of the adrenal glands. CONCLUSION. Intense enhancement (as great as that of adjacent vascular structures) of normal-shaped adrenal glands occurs in association with hemodynamic instability in children. The presence of intense adrenal enhancement may provide additional evidence of hemodynamic instability and help differentiate it from direct bowel injury.