Sigel A, Schafhauser W
Urologische Klinik, Universität Erlangen-Nürnberg.
Urologe A. 1990 Nov;29(6):334-7.
From the aspect of morbidity, adrenal apoplexy is primarily a disease of newborns or infants, frequently with subclinical rather than frank manifestations. The development is governed by the susceptibility fetal processes of adrenal transformation to disturbances and injury. Exogenous causes such as birth trauma and bacterial inflammation, are seen in some cases, as are sympathogenous neoplasms. When it is diagnosed some uncertainty about benign or malignant development of the disorder persists in the background. With sonography now available as a diagnostic tool, in the majority of the cases conservative monitoring for a tendency to spontaneous resorption is enough. This approach, however, also involves the risk of identifying a protracted circulatory shock or the growth of an adrenal tumor too late. The surgeon also faces the problem of possible misinterpretation of hematoma impacted into the fascia of the capsule of Gerota as a nephroblastoma with consequent erroneous treatment. The relative rareness of the disorder means surgeons have little personal experience with it, which compounds the difficulties. In comparison with the situation in children, treatment of the adult form of the disorder appears almost simple.
从发病率方面来看，肾上腺出血主要是新生儿或婴儿的疾病，通常表现为亚临床症状而非明显症状。其发病受肾上腺转化过程中胎儿易感性的影响，易受干扰和损伤。在某些情况下可见外源性病因，如出生创伤和细菌炎症，也可见交感神经性肿瘤。在诊断时，该疾病的良性或恶性发展仍存在一定不确定性。如今超声检查已作为一种诊断工具，在大多数情况下，对其自发吸收倾向进行保守监测就足够了。然而，这种方法也存在风险，即可能过晚发现持续性循环休克或肾上腺肿瘤的生长。外科医生还面临一个问题，即可能将 Gerota 筋膜囊内的血肿误判为肾母细胞瘤，从而导致错误的治疗。该疾病相对罕见，这意味着外科医生对此几乎没有个人经验，这使得困难更加复杂。与儿童患者的情况相比，成人形式的该疾病治疗似乎几乎很简单。
