Fox B
J Pathol. 1976 Jun;119(2):65-89. doi: 10.1002/path.1711190202.
An investigation of 78 cases of adrenal haemorrhage and necrosis disclosed that 32 were examples of adrenal venous infarction. In all these cases there was thrombosis of the main adrenal vein and in most there was also thrombosis of the capsular veins, a finding which has not been well established. In a number of cases with venous infarction there was clinical and pathological evidence that disseminated intravascular coagulation (DIC) had occurred, but it appears that it was not the direct cause of venous thrombosis. The majority of cases of venous infarction occur in patients with severe infection, frequently of the respiratory tract. Venous infarction was found in five cases with hypothermia an association which had rarely been described, and in three of these there was evidence of DIC. This is apparently the first occasion on which DIC has been demonstrated in cases of hypothermia in man. The cause of venous thrombosis in the adrenal glands is obscure in most cases of venous infarction, although in three it was due to involvement by metastatic carcinoma. It is suggested that the factors responsible for the initiation of thrombosis in the adrenal veins are catecholamines, thrombin, fibrin and endotoxin. Localisation of the thrombi to the adrenal vein is due to the unique anatomical structure of the vein which, under certain circumstances, results in the local stasis of blood.
对78例肾上腺出血和坏死的调查显示，其中32例为肾上腺静脉梗死。在所有这些病例中，肾上腺主静脉均有血栓形成，且大多数病例的包膜静脉也有血栓形成，这一发现尚未得到充分证实。在一些静脉梗死病例中，有临床和病理证据表明发生了弥散性血管内凝血（DIC），但似乎它并非静脉血栓形成的直接原因。大多数静脉梗死病例发生在严重感染患者中，常见于呼吸道感染。在5例体温过低患者中发现了静脉梗死，这种关联很少被描述，其中3例有DIC证据。这显然是首次在人体体温过低病例中证实存在DIC。在大多数静脉梗死病例中，肾上腺静脉血栓形成的原因尚不清楚，不过有3例是由于转移性癌累及所致。有人提出，肾上腺静脉血栓形成起始的相关因素为儿茶酚胺、凝血酶、纤维蛋白和内毒素。血栓定位于肾上腺静脉是由于该静脉独特的解剖结构，在某些情况下会导致局部血液淤滞。
