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We describe 14 patients with adrenal injuries from penetrating (ten) or blunt (four) trauma. The severity of their injuries was evidenced by the high incidence of hypovolemic shock (57%), mean Trauma Score (11), mean transfusion requirement (18 Units), number of associated injuries (4.9 per patient), complication rate (57%), and deaths (14%). Twelve patients required surgical exploration; adrenal repair, rather than removal, was possible in seven. Although adrenal insufficiency was suspected in three patients, it was not documented and no patient required corticosteroid replacement.