孕早期自发性肾上腺出血
Spontaneous adrenal haemorrhage in early pregnancy.
作者信息
Keizer Alieke L, Peters Louisette W, de Vries Cees, Smets Yves F C, de Wit Laurens Th, van Pampus Mariëlle G
机构信息
Department of Obstetrics & Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.
出版信息
BMJ Case Rep. 2013 Aug 16;2013:bcr2012008062. doi: 10.1136/bcr-2012-008062.
A 32-year-old primigravida presented at our emergency room at 6 weeks of gestation with acute severe right upper quadrant abdominal pain, radiating to the right flank. Vital signs were stable. Abdominal ultrasound showed a round inhomogeneous mass of 10 cm diameter behind the right kidney, suspected for adrenal haemorrhage. The patient was admitted for observation. An MRI showed some right-sided pleural effusion and a round mass in the adrenal region with no recognisable adrenal gland, therefore most likely originating from the right adrenal. After 10 days the patient was discharged with no change in size of the haematoma. MRI was carried out every 2 months which showed a decrease in size of the haematoma, with no other abnormalities. Based on stable MRI and the patient's preference, a vaginal delivery mode was chosen. At 37 weeks of gestation labour was induced, followed by an uncomplicated delivery.
一名32岁初产妇在妊娠6周时因急性严重右上腹疼痛放射至右腰侧而就诊于我们的急诊室。生命体征稳定。腹部超声显示右肾后方有一个直径10厘米的圆形不均匀肿块，怀疑为肾上腺出血。患者入院观察。磁共振成像（MRI）显示右侧有一些胸腔积液，肾上腺区域有一个圆形肿块，未见可识别的肾上腺，因此最有可能起源于右肾上腺。10天后患者出院，血肿大小无变化。每2个月进行一次MRI检查，结果显示血肿大小减小，无其他异常。基于MRI结果稳定以及患者的意愿，选择了阴道分娩方式。妊娠37周时引产，随后分娩过程顺利。
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