Galatola Roberta, Gambardella Michele, Mollica Carmine, Calogero Armando, Magliulo Mario, Romeo Valeria, Maurea Simone, Mainenti Pier Paolo
Department of Advanced Biomedical Sciences, University "Federico II", Via Sergio Pansini 5, 80131, Naples, Italy.
Institute of Biostructures and Bioimaging of the National Council of Research (CNR), Naples, Italy.
Radiol Case Rep. 2020 Apr 21;15(6):803-807. doi: 10.1016/j.radcr.2020.03.013. eCollection 2020 Jun.
We present a case of a middle-age male who presented in emergency room with nonspecific abdominal pain. A contrast-enhanced computer tomography (ceCT) scan showed a reduced perfusion of both adrenal glands. The clinical examinations and the laboratory tests were negative for an adrenal pathological process. To reassess the adrenal ischemia, a second ceCT scan was performed 5 days later showing an acute bilateral adrenal hemorrhage. These findings demonstrated that the previous adrenal hypoperfusion represented the prodromal manifestation of a hemorrhagic intraglandular process. This case suggests that adrenal hypoperfusion detected on tomographic imaging dictates a prompt clinical management finalized to strictly monitor the potential evolution towards a more aggressive pathological condition and confirms the pivotal role of imaging in the diagnosis of such uncommon disorder.
我们报告一例中年男性患者，该患者因非特异性腹痛就诊于急诊室。增强计算机断层扫描（ceCT）显示双侧肾上腺灌注减少。临床检查和实验室检查均未发现肾上腺病理过程。为重新评估肾上腺缺血情况，5天后进行了第二次ceCT扫描，结果显示双侧肾上腺急性出血。这些发现表明，之前的肾上腺灌注不足是腺体内出血过程的前驱表现。该病例提示，断层成像检测到的肾上腺灌注不足需要及时进行临床处理，以便严格监测其向更严重病理状态发展的潜在过程，并证实了成像在诊断这种罕见疾病中的关键作用。
