Adrenal Haemorrhages and Burns - An Autopsy Study

An estimated 1,95,000 deaths every year are caused by burns–the vast majority occurs in lowand middleincome countries. In India, over 10, 00,000 people are moderately or severely burnt every year. Women in the WHO South-East Asia Region have the highest rate of burns, accounting for 27% of global burn deaths and nearly 70% of burn deaths in the region. Adrenal haemorrhage occurs secondary to both traumatic conditions and atraumatic conditions. Burns accounts for maximum number of cases of traumatic haemorrhages. The purpose of this study was to investigate the prevalence of adrenal haemorrhage in non-surviving patients with burns by evaluating the compiled autopsy study data. During the period between 1st July 2009 to 31st June 2011, totally 51 burns cases were autopsied, among them, adrenal haemorrhage was seen in 14 cases, of which 10 cases showed bilateral haemorrhages and 04 cases showed unilateral haemorrhages. Extensive, bilateral adrenal haemorrhages were more commonly seen in males. Acute adrenal insufficiency is an uncommon but devastating complication of severe burn injury. The diagnosis is rarely made ante-mortem. The clinical importance of bilateral adrenal haemorrhage is that it may lead to acute adrenal insufficiency and possible death. Therefore, when a sudden deterioration in the patient with thermal injuries is encountered, adrenal insufficiency must be considered.