Isolated unilateral adrenal hemorrhage (case Report)

Background: Isolated adrenal hemorrhage is an uncommon condition and its diagnosis is usually made during autopsy. Adrenal hemorrhage (AH) is one of the very rare complications of trauma in adults. AH is associated with meningococcal septicemia and disseminated intravascular coagulation (water house–Friderichsen syndrome). Hypotension, tumors, complications of pregnancy, surgical stress and anticoagulation therapy may also cause AH.

Case Report: The case was a 19 year-old athlete with abdominal pain in RUQ from 3days ago in association with nausea, vomiting, loss of appetite, and history of minor abdominal trauma that was admitted to the emergency ward, diagnostic measures  such as abdominal ultrasound and CT Scan revealed a hematoma like mass in right adrenal. During operation a hemorrhagic adrenal mass like was founded the patient underwent adrenalectomy with evacuation of hematoma. Pathologic examination confirmed an adrenal hemorrhage and necrosis.

Conclusion: Because of specific anatomic location of Rt. Adrenal gland and high concentration of catecholamines, minor abdominal trauma may cause insidious, isolatated unilateral adrenal hemorrhage.