Abstract
Adrenal hemorrhage (AH) is a rare but life-threatening condition. Small focal hemorrhage may present subclinically, but massive hemorrhage may lead to rapid cardiovascular collapse and ultimately death if not diagnosed appropriately and treated quickly. Most cases reported in the literature have been treated conservatively. In an event of increasing hemorrhage during conservative management, it may be tricky to intervene surgically because of the hematoma around the gland. Here we describe a case where we managed a large spontaneous AH by a combination of angioembolization and laparoscopic adrenalectomy.
Highlights
Introduction and BackgroundAdrenal hemorrhage (AH) is a rare but lifethreatening condition, especially when it occurs bilaterally
Small focal hemorrhage may present subclinically, but massive hemorrhage may lead to rapid cardiovascular collapse and death if not diagnosed appropriately and treated quickly
Clinical manifestation depends on the degree and rate of hemorrhage
Summary
Adrenal hemorrhage (AH) is a rare but lifethreatening condition, especially when it occurs bilaterally. Ultrasound (USG) abdomen and, later, contrast-enhanced CT scan abdomen were performed, which revealed hemorrhagic collection of 9 · 8.2 · 8.2 cm near the left suprarenal region with 4 · 4.5 ·4.2 cm adrenal mass. There was one blood pressure recording of >160 mm Hg (systolic) He complained of resurgence in pain, so a bed-side USG of the abdomen was performed, which revealed an increase in collection by 500 mL resulting in a drop of Hb by 2 gm/dL. He was transfused 2 units of packed red blood cells. Follow-up performed after 6 and 12 months revealed no abnormality in positron emission tomography CT scan
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