Adrenal gland haemorrhages following motor vehicle accident with resultant adrenal insufficiency.

Adrenal gland haemorrhage is an under-diagnosed consequence of high-impact trauma. Trauma patients with adrenal haemorrhage have a significantly increased mortality risk. Bilateral adrenal gland haemorrhage can result in life-threatening adrenal insufficiency requiring urgent glucocorticoid replacement. Biochemical assessment of the adrenocortical axis should be considered in all patients presenting with high-impact trauma following motor vehicle accidents. Given the potential for delayed presentation, any patients with new haemodynamic instability should have repeat biochemistry and/or imaging performed, even if initial adrenal imaging and investigations were normal.