大多數外傷性腎上腺出血通常合併胸部或腹部的傷害，呈現多處器官的問題，腹部鈍傷所造成單獨腎上腺出血是很少見的。本篇我們報告兩個腹部鈍傷所造成單獨右側腎上腺出血的案例，案例一：用保守療法治療成功，腎上腺血腫在超音波追蹤四個月後，自動消失。案例二：病人接受右側腎腺切除，病理切片檢查證實為腎上腺血腫。回顧文獻有四種造成這種單獨外傷性腎上腺出血的可能機轉被提出。我們建議：在腹部鈍傷後所意外發現的腎上腺腫塊，既使沒合併其他胸部或腹部傷害，外傷性腎上腺出血仍須列入考慮，電腦斷層掃瞄對於診斷外傷性腎上腺出血俱有專一性，唯一的鑑別診斷是區分是否合併腎上腺腫瘤。處理外傷性腎上腺出血一般採取保守療法，經常性的超音波追蹤，可發現血腫逐漸吸收至消失不見，藉此可確認腎上腺外傷性血腫的診斷並排除合併腎上腺腫瘤的可能性。

Most cases of post-traumatic adrenal hemorrhage present with concomitant severe chest or abdominal injuries, expressing multiple organ problems. Isolated adrenal injuries following blunt abdominal trauma are rare. Herein, we report 2 cases of isolated right adrenal hematoma following blunt abdominal trauma. One patient was successfully conservatively. Ultrasonography showed that the hemato-ma resolved spontaneously after 4-mo’s follow-up. The other patient received adrenalectomy, and the pathology confirmed the diagnosis of adrenal hematoma. Four possible mechanisms of adrenal hematoma after blunt abdominal trauma have been proposed in the literature and are discussed in this paper. We suggest that when an incidental adrenal mass is found after blunt abdominal trauma, even in a minor injury not associated with other intra-abdominal injuries, the possibility of adre-nal hemorrhage should be considered. Serial follow-up with ultrasonography is useful to confirm the diagnosis and to rule out the possibility of an underlying neoplasm.(J Urol R.O.C.,10:177-181,1999)