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妊娠合并自发性肾上腺出血:文献复习

Spontaneous adrenal haemorrhage in pregnancy and review of the literature.

机构信息

Obstetrics and Gynaecology, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire, UK

Obstetrics and Gynaecology, Lister Hospital, Stevenage, UK.

出版信息

BMJ Case Rep. 2022 May 6;15(5):e246240. doi: 10.1136/bcr-2021-246240.

Abstract

Spontaneous adrenal haemorrhage (SAH) is a rare condition. The incidence of adrenal haemorrhage in pregnancy is currently not known; however, an association with pregnancy has been reported.An acute presentation with severe back or flank pain should raise suspicion of this condition. Diagnosis is based on imaging. An ultrasound scan is a basic and readily available investigation in pregnancy to rule out renal and suprarenal pathology while CT or MRI scan can help to confirm the diagnosis. A multidisciplinary team (MDT) approach, involving the obstetric, anaesthetic, medical and endocrine team, is essential in management of this condition.We present a case of an SAH; managed conservatively, in an otherwise healthy and low-risk pregnant woman and describe the literature review on this rare condition, including pathophysiology and management.

摘要

自发性肾上腺出血(SAH)是一种罕见的病症。目前尚不清楚妊娠期间肾上腺出血的发病率;然而,已有报道称其与妊娠有关。如果出现严重的背痛或侧腹痛的急性表现,应怀疑这种情况。诊断基于影像学。在妊娠期间,超声检查是一种基本且易于获得的检查方法,可以排除肾脏和肾上腺病变,而 CT 或 MRI 扫描有助于确诊。多学科团队(MDT)的方法,包括产科、麻醉、内科和内分泌科团队,对于这种情况的治疗至关重要。我们报告了一例 SAH 的病例;在一位健康且低风险的孕妇中进行了保守治疗,并描述了关于这种罕见病症的文献综述,包括病理生理学和管理。

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本文引用的文献

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Spontaneous adrenal hematoma in pregnancy: A case report.妊娠期自发性肾上腺血肿:一例报告
Medicine (Baltimore). 2018 Nov;97(47):e13329. doi: 10.1097/MD.0000000000013329.
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Nontraumatic adrenal hemorrhage: the adrenal stress.非创伤性肾上腺出血:肾上腺应激
Radiol Case Rep. 2017 Apr 15;12(3):483-487. doi: 10.1016/j.radcr.2017.03.020. eCollection 2017 Sep.
4
Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series.妊娠期自发性肾上腺出血:病例系列
Case Rep Obstet Gynecol. 2017;2017:3167273. doi: 10.1155/2017/3167273. Epub 2017 Mar 22.
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Spontaneous adrenal haemorrhage in early pregnancy.孕早期自发性肾上腺出血
BMJ Case Rep. 2013 Aug 16;2013:bcr2012008062. doi: 10.1136/bcr-2012-008062.
8
Spontaneous adrenal haemorrhage in pregnancy.妊娠期自发性肾上腺出血
BMJ Case Rep. 2011 Sep 13;2011:bcr0720114496. doi: 10.1136/bcr.07.2011.4496.
9
Clinical update on the management of adrenal hemorrhage.肾上腺出血管理的临床进展
Curr Urol Rep. 2009 Jan;10(1):78-83. doi: 10.1007/s11934-009-0014-y.

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