Clark O H
Ann Surg. 1975 Aug;182(2):124-9. doi: 10.1097/00000658-197508000-00007.
Twelve elderly patients without Waterhouse-Friderichsen syndrome or adrenal tumor who had spontaneous adrenal hemorrhage one to 33 days after operation are described. Seven of these patients had operations on the gastrointestinal tract, one on the biliary system, two on the genitourinary system and two on the central nervous system. Important factors relating to adrenal hemorrhage included: intra-abdominal sepsis in 5 patients, cancer in 4, pneumonia in 4, coagulation defects in 2, exogenous steroids in 2, and syphilis in one patient. Spontaneous adrenal hemorrhage should be considered in patients whose condition deteriorates rapidly after operation and in whom no other explanation is plausible. Its detection and appropriate therapy can be lifesaving.
本文描述了12例无华-佛综合征或肾上腺肿瘤的老年患者，他们在术后1至33天发生自发性肾上腺出血。其中7例患者接受了胃肠道手术，1例接受了胆道系统手术，2例接受了泌尿生殖系统手术，2例接受了中枢神经系统手术。与肾上腺出血相关的重要因素包括：5例患者存在腹腔内感染，4例患者患有癌症，4例患者患有肺炎，2例患者存在凝血缺陷，2例患者使用了外源性类固醇，1例患者患有梅毒。对于术后病情迅速恶化且无其他合理原因的患者，应考虑自发性肾上腺出血。其检测和适当治疗可挽救生命。
