Diagnosis and treatment of adrenal hemorrhage

Abstract

Objective To investigate the diagnosis and therapy by improving the further understanding of adrenal hemorrhage. Methods The clinical data of 12 cases of adrenal hemorrhage confirmed by pathology admitted to the First Hospital of China Medical University from October 2006 to October 2017 were retrospectively analyzed. Observe the patient′s clinical manifestations, imaging features, treatment methods and prognosis. Results All 12 cases were unilateral adrenal hemorrhage, 8 cases manifested lumbago in troubled side, 2 cases manifested abdominal pain, and 2 cases were found during physical examination incidentally with no obvious symptoms. Ultrasound-B was performed in 10 cases, revealed low echo of masses in 5 cases, mixed echo of masses in 2 cases, cystic echo of masses in 2 cases, and no abnormality in 1 case. All 12 cases were scanned by CT, 9 cases showed cystic masses with mixed density, and 3 cases showed solid masses. The value of plain CT ranged from 31 HU to 77 HU, no obvious enhancement was found in enhanced scan. One case was scanned by MRI, showed round mass in left adrenal gland, with uneven signal. The main signal was iso-signal in T1-weighted and T2-weighted. Six cases underwent adrenal and mass resection through the 11th rib, 3 cases underwent retroperitoneoscopic adrenalectomy, 2 cases underwent abdominal exploration and accepted adrenalectomy and hematoma removal, and 1 case was discharged after conservative treatment because of surgery contraindication. 11 cases of the pathology of postoperation were adrenal hemorrhage. Conclusions Preoperative diagnosis of adrenal hemorrhage is relatively difficult, ultrasound-B, CT, and MRI examination can help diagnose.Surgical treatment should be performed for patients who can tolerate surgery and with larger hematoma (>5 cm). Key words: Adrenal glands; Hemorrhage; Diagnosis; Therapy