Adrenal Injury in Situs Inversus

Yuichiro Haba1, and Naoyuki Hashiguchi2
1Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
2Department of Emergency and Disaster Medicine, Juntendo University School of Medicine, Tokyo, Japan

Corresponding author: Yuichiro Haba,

DOI: 10.31662/jmaj.2022-0128

Received: June 6, 2022
Accepted: November 24, 2022
Advance Publication: March 6, 2023
Published: April 14, 2023

Cite this article as:
Haba Y, Hashiguchi N. Adrenal Injury in Situs Inversus. JMA J. 2023;6(2):204-205.

Key words: Blunt adrenal injury, Situs inversus, Primary care

A 43-year-old man presented to our primary care clinic with back pain and contusions following a motorcycle accident. Contrast-enhanced computed tomography revealed complete situs inversus, left upper rib fractures, left adrenal enlargement, and no evidence of extravasation or other organ damage. The left adrenal gland measured 3.1 cm along the major axis (Figure 1: arrow) and periadrenal fat stranding (Figure 1: arrowheads) was observed. Serum hormone tests ruled out neoplasia and the enlargement was attributed to trauma (1). Blunt trauma predominantly affects the right adrenal gland (1), (2), (3) owing to its proximity to vertebrae and drainage through the inferior vena cava (1), (4); the patient’s left-sided injury could be attributed to situs inversus. As with other reports (2), (3), (4), this case was nonoperative and successfully managed in the primary care setting. Our incidental discovery of situs inversus highlights one potentially disastrous consequence of estimating injury severity based on conventional anatomical features and eschewing diagnostic imaging.

Figure 1. Contrast-enhanced computed tomography showing an enlarged adrenal gland with a 3.1-cm major axis (arrows) and stranding of the periadrenal fat (arrowheads). Other organs are intact. (A): Transverse section. (B): Coronal section.

Article Information

Conflicts of Interest


Author Contributions

All authors contributed to patient care. YH conceived the idea for the study and wrote the manuscript. NH contributed to the editing of the manuscript.

Approval by Institutional Review Board (IRB)

An IRB approval is not required because this is a case report.

Informed Consent

Written informed consent was obtained from the patient for publication.


  1. 1.

    Sinelnikov AO, Abujudeh HH, Chan D, et al. CT manifestations of adrenal trauma: experience with 73 cases. Emerg Radiol. 2007;13(6):313-8.

  2. 2.

    Tanizaki S, Maeda S, Ishida H. Blunt adrenal gland injury: the impact of extra-abdominal injury. J Trauma Acute Care Surg. 2021;91(4):716-8.

  3. 3.

    Al-Thani H, El-Matbouly M, El-Menyar A, et al. Adrenal gland trauma: an observational descriptive analysis from a level 1-trauma center. J Emerg Trauma Shock. 2021;14(2):92-7.

  4. 4.

    de Camargo Galindo GF, Pagamisse OST, De Lima R, et al. Nonoperative treatment of a blunt adrenal gland trauma with blush: a case report. Trauma Case Rep. 2021;32:100454.