Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma

Amano, Toshiyasu; Takemae, Katsuro; Niikura, Susumu; Kouno, Masanori; Amano, Masashi

doi:10.1046/j.1442-2042.1999.611109.x

Cited by 33 publications

(18 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Persistent bleeding with symptoms of hemorrhagic hypovolemia like refractory hypotension and altered consciousness are considered to be absolute indications for immediate surgical intervention [14]. The CT findings of the lesions with bleeding are not easy to identify.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

Liu¹,

Chang

Chien

et al. 2017

BMC Surg

View full text Add to dashboard Cite

BackgroundAdrenal myelolipoma is an uncommon, benign, and hormonally non-functioning tumor that is composed of mature adipose tissue and normal hematopoietic tissue. Most cases to date are asymptomatic or have epigastric pain. Acute hemorrhage is the most dramatic manifestation of adrenal myelolipoma; though, it is a rare entity. Hemorrhagic shock due to adrenal myelolipoma, to our knowledge, was much less mentioned so far. Persistent bleeding and uncontrollable hypotension are considered to be absolute indications for immediate surgical operation.Case presentationHerein we presented a 32-year-old male patient with initial symptoms of nausea, vomiting, and epigastric pain progressing to altered consciousness and hypotension during ER course. Hemorrhagic shock due to a giant adrenal myelolipoma, R’t was diagnosed. Emergent exploratory laparotomy was executed, and en bloc excision of tumor was done.ConclusionAdrenal myelolipoma might be diagnosed as a adjunction to other main causes of illness; furthermore, adrenal myelolipoma could be asymptomatic in lifetime. In our case, however, manifesting as hemorrhage shock was challenging to diagnose step by step; instead, maintaining vital organs perfusion and identifying bleeding sources were to be done. Management of myelolipoma should be done on a case-to-case basis.

show abstract

Section: Discussionmentioning

confidence: 99%

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

Liu¹,

Chang

Chien

et al. 2017

BMC Surg

View full text Add to dashboard Cite

show abstract

“…The incisive canals pass through on each side of the nasal septum to extend from the nasal cavity to the oral cavity, already on the path to the oral cavity, these channels join and leave in an opening in the common area of the incisive papilla. The NPD is an organ that humans have only remnants of epithelium within the incisive canal, which can give rise to the nasopalatine cyst (NPC) [12][13].…”

Section: Discussionmentioning

confidence: 99%

Nasopalatine Cyst: A Silent Growing Lesion

Capelozza¹

2017

BJSTR

View full text Add to dashboard Cite

show abstract

“…En raras ocasiones, llega a ser causa de hemorragia retroperitoneal masiva 3 . Tales hematomas, generalmente pasan desapercibidos por lo que, al igual que el mielolipoma, se descubren de forma casual en pruebas de imagen tras largo tiempo de evolución 1,4 .…”

unclassified

Hematoma suprarrenal por rotura de mielolipoma: A propósito de un caso

et al. 2004

View full text Add to dashboard Cite

RESUMENHEMATOMA SUPRARRENAL POR ROTURA DE MIELOLIPOMA. A PROPÓSITO DE UN CASO El mielolipoma es un tumor benigno de la corteza suprarrenal, no funcionante y normalmente asintomático, que suele diagnosticarse de forma incidental en pruebas de imagen. La rotura y sangrado del mielolipoma es una complicación poco habitual, que puede concluir en la organización de un hematoma o, raramente, ocasionar hemorragia retroperitoneal masiva. La compresión de estructuras adyacentes por hematomas retroperitoneales (HR) de origen adrenal, es un evento poco frecuente. La indicación quirúrgica del HR continúa siendo, hoy día, una decisión difícil y controvertida, pues suele resolverse con tratamiento conservador y actitud expectante.Presentamos el caso de un varón de 69 años de edad, que acudió a Urgencias por dolor abdominal de 7 días de evolución, cuyo inicio coincidió con traumatismo leve. Las pruebas de imagen revelaron la existencia de hematoma retroperitoneal derecho de 16 cm de posible origen adrenal, con signos de sangrado activo, que colapsaba y desplazaba vena cava. Tan sólo hemos encontrado 1 caso descrito en la literatura de compresión de vena cava secundario a hematoma dependiente de glándula suprarrenal.En nuestro caso fue necesaria laparotomía urgente, suprarrenalectomía derecha y exéresis del hematoma.PALABRAS CLAVE: Mielolipoma. Hematoma retroperitoneal. Glándula suprarrenal. ABSTRACT ADRENAL GLAND HEMATOMA DUE TO RUPTURE OF MYELOLIPOMA. A CASE REPORTThe myelolipoma is a benign tumour of the adrenal cortex, non functioning and normally asymptomatic, which can be diagnosed by chance in imaging test. Rupture and bleeding of the myelolipoma is an infrequent complication, which can conclude with the formation of a haematoma or, less usually, result in a massive retroperitoneal haemorrhage. The compression of adjacent structures by retroperitoneal haematomas with adrenal origin is a possible but not frequent eventuality.Indications for surgery of haematoma retroperitoneal continue to be, nowadays, a difficult and controversial decision, because the problem is normally resolved with conservative treatment and a watchful approach.We are presented with a 69 year old male who came to casualty with abdominal pain of 7 days duration, whose origin coincided with a light blow. The image test revealed the existence of a retroperitoneal haematoma with adrenal gland origin of 16 cm, with active bleeding, which was displaced and compressed the cava vein. We have only found one case, in the literature, of compression of the cava vein coused by adrenal gland haematoma. In the case under our observation, urgent surgery was needed.

show abstract

Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma

Abstract: A CT scan is very useful in the pre-operative diagnosis of adrenal myelolipoma with retroperitoneal hemorrhage. Watch and wait treatments before operation and nephrectomy with adhered tumor are safe and curative.

Cited by 33 publications

References 7 publications

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

Nasopalatine Cyst: A Silent Growing Lesion

Hematoma suprarrenal por rotura de mielolipoma: A propósito de un caso

Contact Info

Product

Resources

About