Alidoost Marjan, Soomro Rabail, Gubeladze Ana, Morabia Albert, Holland Soemiwati, Asif Arif, Hossain Mohammad A
Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA.
Am J Case Rep. 2019 Nov 2;20:1607-1611. doi: 10.12659/AJCR.917780.
BACKGROUND Adrenal hemorrhage is an uncommon and under-recognized disorder with a wide array of etiologies ranging from pregnancy to septic shock. It is one of the complications of anticoagulation therapy, including direct anticoagulant medications. CASE REPORT Here, we present a case of a 68-year-old female with recent right knee arthroplasty who was on rivaroxaban for deep vein thrombosis (DVT) prophylaxis presented to the emergency department (ED) for severe acute onset abdominal pain, computed tomography (CT) of abdomen and pelvis revealed possible left adrenal hemorrhage that was confirmed with magnetic resonance imaging (MRI). On repeat CT, her unilateral adrenal hemorrhage converted to a bilateral adrenal hemorrhage (BAH) and, as a result, the patient developed adrenal insufficiency. CONCLUSIONS An undiagnosed and untreated adrenal hemorrhage can have catastrophic consequences, leading to adrenal insufficiency with potential shock and death. Therefore, it is important for clinicians to have an increased awareness and knowledge about adrenal hemorrhage.
肾上腺出血是一种罕见且未得到充分认识的疾病，病因广泛，从妊娠到感染性休克不等。它是抗凝治疗的并发症之一，包括直接抗凝药物。病例报告：在此，我们报告一例68岁女性病例，该患者近期行右膝关节置换术，正在服用利伐沙班预防深静脉血栓形成（DVT），因严重急性腹痛就诊于急诊科（ED）。腹部和盆腔计算机断层扫描（CT）显示可能存在左肾上腺出血，磁共振成像（MRI）证实了这一情况。在复查CT时，她的单侧肾上腺出血转变为双侧肾上腺出血（BAH），结果患者出现了肾上腺功能不全。结论：未诊断和未治疗的肾上腺出血可能会产生灾难性后果，导致肾上腺功能不全，有潜在休克和死亡风险。因此，临床医生提高对肾上腺出血的认识和了解非常重要。
