Di Serafino Marco, Severino Rosa, Coppola Valeria, Gioioso Matilde, Rocca Rosario, Lisanti Francesco, Scarano Enrico
Radiology Department, San Carlo Hospital, Potito Petrone St, 85100 Potenza, Italy.
Emergency-Urgency Department, San Carlo Hospital, Potenza, Italy.
Radiol Case Rep. 2017 Apr 15;12(3):483-487. doi: 10.1016/j.radcr.2017.03.020. eCollection 2017 Sep.
Bilateral adrenal hemorrhage is a rare condition, which is burdened by potentially life-threatening consequences related to the development of acute adrenal insufficiency. Despite treatment with stress-dose glucocorticoids, a mortality rate of 15% has been reported, which varies according to the severity of underlying predisposing illness and could be much more higher if the adrenal insufficiency is not promptly recognized. An early diagnosis is crucial, though, because of nonspecific clinical and laboratory findings, adrenal hemorrhage is rarely suspected. Therefore, imaging has a pivotal role for the diagnosis of this uncommon condition but, despite adrenal hematomas characteristically appear round or oval with peripheral fat stranding, their initial presentation could be ambiguous. The authors describe a case of postoperative bilateral adrenal hemorrhage initially presenting at computed tomography scan as thickening of both glands surrounded by fat stranding, which led to close monitoring of adrenal function before unequivocal hemorrhage developed.
双侧肾上腺出血是一种罕见疾病，因急性肾上腺功能不全的发展可能导致危及生命的后果而备受关注。尽管使用了应激剂量的糖皮质激素进行治疗，但据报道死亡率为15%，该死亡率因潜在易感疾病的严重程度而异，如果肾上腺功能不全未得到及时识别，死亡率可能会更高。然而，早期诊断至关重要，由于临床和实验室检查结果不具特异性，很少有人怀疑肾上腺出血。因此，影像学检查对于诊断这种罕见疾病起着关键作用，尽管肾上腺血肿典型表现为圆形或椭圆形并伴有周围脂肪条索影，但其最初表现可能不明确。作者描述了一例术后双侧肾上腺出血病例，最初在计算机断层扫描中表现为双侧肾上腺增厚并伴有脂肪条索影，这使得在明确出血发生之前对肾上腺功能进行了密切监测。
