We report a case of a giant adrenal pseudocyst, found incidentally in a 45 year old female. Her CT scan showed a 7.5cm x 7.3cm suprarenal mass and she underwent a laparoscopic transperitoneal adrenalectomy. We report this case and review the literature regarding the diagnosis and management of adrenal pseudocysts. CASE REPORTA 45 year old housewife with multiple sclerosis was discovered to have a large right suprarenal mass as an incidental finding on a computed tomography (CT) scan of her lumbosacral spine. On close questioning, she reported a vague history of episodes of right flank pain for the previous 2 years. She also described episodes of flushing and lethargy which raised a suspicion of a possible diagnosis of phaeochromocytoma. There was no prior history of trauma or malignancy. The examination was normal other than a palpable mass in the right upper quadrant.An adrenal protocol CT scan was performed revealing a 7.5cm x 7.3cm suprarenal cystic lesion with a calcified rim (Figs. 1,2). A renal or adrenal origin of the mass was difficult to distinguish. Otherwise, no metastatic disease was seen. The possibility of a phaeochromocytoma was considered, although these tumors normally display enhancement. Figs. (1,2). CT abdomen with contrast showing 7.5cm x 7.3cm mass in the supra-renal area. The calcified rim is well depicted here.

In automobile accidents, the "seatbelt syndrome" (SBS) consists of a constellation of injuries, predominantly involving thoraco-lumbar vertebral fractures and intraabdominal organ injury. A recent amendment to Irish legislation has made the wearing of seatbelts mandatory for all rear seated passengers in an effort to protect children. Whilst rear seatbelts result in a significant reduction in morbidity and mortality following road traffic accidents (RTA), we present a case in which the rear lap seatbelt caused severe abdominal injuries. It is evident that the current rear seat lapbelt system is an inferior design associated with a significant morbidity and mortality when compared to three-point harness system and consideration should be given to replacing them in all motor vehicles.