Sakalkale Aditya, Choi Colin Chan-Min, Krawitz Russel, Yeung Justin M C
Department of General Surgery, Western Health, Melbourne, Australia.
Department of Colorectal Surgery, Western Health, Melbourne, Australia.
Radiol Case Rep. 2024 Mar 26;19(6):2395-2401. doi: 10.1016/j.radcr.2024.03.005. eCollection 2024 Jun.
Adrenal hemorrhage (AH) is an uncommon and potentially disastrous affliction that carries an accepted mortality risk of 15%. Variable symptomatology can cause a diagnostic dilemma and may be missed. We present 2 cases of right-sided AH; both cases were initially presumed to be renal colic. Case 1 was an 86-year-old gentleman, presenting with right flank pain found to have a right-sided atraumatic AH. He presented with hemorrhagic shock, requiring angioembolization of the bleeding vessel. Case 2 was a 62-year-old gentleman who presented with right flank pain and was found to have a right-sided atraumatic AH. He was hemodynamically stable and successfully managed conservatively. Adrenal hemorrhage is a potentially fatal affliction that may be missed. CT scans are the recommended imaging modality during an acute presentation due to wider availability and fast assessment. We demonstrate a hemodynamically stable patient managed with a 'watch and wait' approach and an unstable patient managed with resuscitation followed by urgent angioembolization.
肾上腺出血（AH）是一种罕见且可能致命的疾病，公认的死亡风险为15%。其症状多变，可导致诊断困难，甚至可能被漏诊。我们报告2例右侧肾上腺出血病例；这2例最初均被误诊为肾绞痛。病例1为一名86岁男性，因右侧胁腹疼痛就诊，检查发现为右侧非创伤性肾上腺出血。他出现失血性休克，需要对出血血管进行血管栓塞治疗。病例2为一名62岁男性，因右侧胁腹疼痛就诊，检查发现为右侧非创伤性肾上腺出血。他血流动力学稳定，经保守治疗成功康复。肾上腺出血是一种可能致命的疾病，可能会被漏诊。由于CT扫描更易获得且评估迅速，因此在急性发病时推荐使用CT扫描进行成像检查。我们展示了一名血流动力学稳定的患者采用“观察等待”方法进行治疗，以及一名不稳定患者先进行复苏然后紧急血管栓塞治疗的情况。
