A Case of Adrenal Hemorrhage Presenting as an Abdominal Emergency.

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We experienced a case of adrenal hemorrhage presenting as an abdominal emergency. A 46-year-old man was admitted to our hospital complaining of a sudden onset of severe left lumbago and back pain. Abdominal CT revealed a large hematoma in the upper portion of and around the left kidney in the left side of the retroperitoneum. An emergency operation was performed under the diagnosis of retroperitoneal hemorrhage of unknown origin. On incising the abdomen, a diffuse hematoma was found to be present mainly in the left side of the retroperitoneum. On removing the coagulum medial to the upper pole of the left kidney, bright red blood, which was presumed to be arterial blood, spouted from the lower pole of the left adrenal gland. On removing the adrenal gland, the blood spouting stopped. On pathological examination, the extracted specimen was found to be the adrenal gland with hemorrhage, and no tumor, for example a pheochromocytoma, existed. Hypertension, which was difficult to control, continued postoperatively, and he was transferred to another hospital for blood pressure control. Conservative treatment is the basic principle for controlling an adrenal hemorrhage. However, it is important to perform an emergency operation if the bleeding cannot be controlled by conservative treatment.
北関東医学会の論文