Idiopathic Spontaneous Adrenal Hemorrhage in the Third Trimester of Pregnancy

Imga, Narin Nasiroglu; Tütüncü, Yasemin; Tuna, Mazhar Müslüm; Doğan, Berçem Ayçıçek; Berker, Dilek; Güler, Serdar

doi:10.1155/2013/912494

Cited by 21 publications

(18 citation statements)

References 5 publications

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“…Non-traumatic adrenal hemorrhage may arise from stressors: bleeding diathesis, percutaneous intravenous procedures, surgery, organ failure, sepsis, pregnancy, [206][207][208] and in relation to tumors such as myelolipoma, pheochromocytoma, or metastases. The adrenal gland has a rich blood supply arising from 3 arteries, with only one draining vein, predisposing to bleeding.…”

Section: Adrenal Hemorrhagementioning

confidence: 99%

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

et al. 2014

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PET/CT with (18)F-fluorodeoxyglucose (FDG) or using different radiocompounds has proven accuracy for detection of adrenal metastases in patients undergoing cancer staging. It can assist the diagnostic work-up in oncology patients by identifying distant metastases to the adrenal(s) and defining oligometastatic disease that may benefit from targeted intervention. In patients with incidentally discovered adrenal nodules, so-called adrenal "incidentaloma" FDG PET/CT is emerging as a useful test to distinguish benign from malignant etiology. Current published evidence suggests a role for FDG PET/CT in assessing the malignant potential of an adrenal lesion that has been 'indeterminately' categorized with unenhanced CT, adrenal protocol contrast-enhanced CT, or chemical-shift MRI. FDG PET/CT could be used to stratify patients with higher risk of malignancy for surgical intervention, while recommending surveillance for adrenal masses with low malignant potential. There are caveats for interpretation of the metabolic activity of an adrenal nodule on PET/CT that may lead to false-positive and false-negative interpretation. Adrenal lesions represent a wide spectrum of etiologies, and the typical appearances on PET/CT are still being described, therefore our goal was to summarize the current diagnostic strategies for evaluation of adrenal lesions and present metabolic and anatomic appearances of common and uncommon adrenal lesions. In spite of the emerging role of PET/CT to differentiate benign from malignant adrenal mass, especially in difficult cases, it should be emphasized that PET/CT is not needed for most patients and that many diagnostic problems can be resolved by CT and/or MR imaging.

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Section: Adrenal Hemorrhagementioning

confidence: 99%

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

et al. 2014

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“…Presenting symptoms are similar to those in nonpregnant patients and include acute onset flank, abdominal or even chest pain, nausea, vomiting, or hypotension [4, 5]. In order to be classified as spontaneous and idiopathic there can be no history of trauma, anticoagulation, tumor, or sepsis [2, 4–6].…”

Section: Discussionmentioning

confidence: 99%

“…A high index of suspicion is necessary to diagnose SAH as most patients present with nonspecific symptoms including abdominal or flank pain and fever [2, 3]. Rarely, patients can develop massive retroperitoneal bleeding and present with hemodynamic instability [1, 4, 5]. If bilateral, SAH can lead to adrenal crisis and shock necessitating emergency laparotomy and adrenalectomy [2, 5].…”

Section: Introductionmentioning

confidence: 99%

“…Rarely, patients can develop massive retroperitoneal bleeding and present with hemodynamic instability [1, 4, 5]. If bilateral, SAH can lead to adrenal crisis and shock necessitating emergency laparotomy and adrenalectomy [2, 5]. We present two cases of symptomatic SAH in the third trimester of pregnancy with successful conservative management.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series

Gupta

Minhas

Quant

2017

Case Reports in Obstetrics and Gynecology

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Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. Conclusion. SAH, although rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient.

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“…Relatively few cases of idiopathic bilateral adrenal hemorrhage have been reported in the worldwide literature [ 5 , 7 , 15 , 17 , 22 ]. Ogino et al [ 7 ] previously described a 54-year-old Japanese woman who was diagnosed with bilateral adrenal hemorrhage due to an unknown cause that resolved 6–12 months later following hydrocortisone therapy.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Bilateral Adrenal Hemorrhage in a 63-Year-Old Male: A Case Report and Review of the Literature

Dhawan

Bodukam

Thakur

et al. 2015

Case Reports in Urology

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Adrenal hemorrhage is a largely uncommon condition typically caused by a number of factors including infection, MI, CHF, anticoagulants, trauma, surgery, and antiphospholipid syndrome. Yet, idiopathic bilateral hemorrhage is rare. The authors present a case of a 63-year-old male who presented with abdominal pain that was eventually diagnosed as bilateral adrenal hemorrhages due to an unknown origin. Abdominal CT revealed normal adrenal glands without enlargement, but an MRI displayed enlargement due to hemorrhage in both adrenals. There was no known cause; the patient had not suffered from an acute infection and was not on anticoagulants, and the patient's history did not reveal any of the other known causative factors. The case underscores the importance of keeping bilateral adrenal hemorrhages on the list of differentials even when a cause is not immediately clear. It also raises the question of whether CT is the most sensitive test in the diagnosis of adrenal hemorrhage and whether the diagnostic approach should place greater weight on MRI. The case highlights the need for prompt therapy with steroids once bilateral hemorrhage is suspected to avert the development or progression of adrenal insufficiency.

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Idiopathic Spontaneous Adrenal Hemorrhage in the Third Trimester of Pregnancy

Cited by 21 publications

References 5 publications

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series

Idiopathic Bilateral Adrenal Hemorrhage in a 63-Year-Old Male: A Case Report and Review of the Literature

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