Andres Sarah, Suchak Nikki, Brady Maureen, Kukar Moshim, Sarkar Joy
Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY 14203, USA.
Nichols School, Buffalo, NY 14216, USA.
J Surg Case Rep. 2023 Jul 31;2023(7):rjad411. doi: 10.1093/jscr/rjad411. eCollection 2023 Jul.
The incidence of bilateral adrenal hemorrhage (BAH) in the postoperative setting is rare, but potentially life threatening. A literature review of postoperative BAH reveals that there is limited data on BAH following abdominal surgery. We present a case of BAH following pancreaticoduodenectomy, which has not been previously documented in the literature. A 70-year-old male patient with no previous history of adrenal disease underwent an uncomplicated pancreaticoduodenectomy and was discharged after a typical postoperative course. He was readmitted with abdominal pain and ileus on POD 8 and a computed tomography (CT) scan was initially unremarkable, but a repeat CT scan on POD 11 demonstrated BAH. He was found to have adrenal insufficiency and was successfully treated with steroids. Clinicians should be aware of the possibility of adrenal hemorrhage postoperatively as it can potentially be a fatal surgical complication. To enhance patient outcomes, early detection and appropriate treatment are essential.
术后双侧肾上腺出血（BAH）的发生率很低，但可能危及生命。对术后BAH的文献综述显示，关于腹部手术后BAH的数据有限。我们报告一例胰十二指肠切除术后发生BAH的病例，此前文献中未见相关记载。一名70岁男性患者，既往无肾上腺疾病史，接受了无并发症的胰十二指肠切除术，术后恢复过程正常，出院。术后第8天，他因腹痛和肠梗阻再次入院，最初的计算机断层扫描（CT）结果无异常，但术后第11天的重复CT扫描显示有BAH。他被诊断为肾上腺功能不全，经类固醇治疗成功康复。临床医生应意识到术后肾上腺出血的可能性，因为它可能是一种致命的手术并发症。为提高患者预后，早期发现和适当治疗至关重要。
