Acute spontaneous unilateral adrenal hemorrhage: etiology and imaging findings in six cases

• Main Authors: Isa Félix Adôrno, Tiago Kojun Tibana, Guilherme Castilho Sorensen de Lima, Leticia de Assis Martins, Walberth Gutierrez Junior, Suzan Menasce Goldman, Thiago Franchi Nunes
• Format: Article
• Language: English
• Published: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2019-02-01
• Series: Radiologia Brasileira
• Subjects: Adrenal glands; Hemorrhage; Tomography, X-ray computed
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019005003101&lng=en&tlng=en

Abstract Objective: To evaluate the computed tomography characteristics of patients admitted with clinical suspicion of acute adrenal hemorrhage at three centers over a 3-year period and in whom that diagnosis was ultimately confirmed. Materials and Methods: This was a retrospective analysis of computed tomography findings in patients with suspected acute adrenal hemorrhage. We included only those cases in which the diagnosis was confirmed. Patients with aortic rupture and retroperitoneal hemorrhage were excluded. The images were analyzed by an experienced radiologist and by two radiology residents. Results: Six cases of unilateral adrenal hemorrhage (three on the left and three on the right) were analyzed. On computed tomography, each appeared as a rounded, oval mass altering the usual anatomy of the adrenal gland. The maximum diameter was 12.2 cm, and attenuation ranged from 45 to 70 HU. There was no appreciable contrast enhancement. No calcifications were observed. Conclusion: Adrenal hemorrhage, albeit rare, is potentially fatal. Early diagnosis is essential. Therefore, recognition of the possible presentations of these lesions by radiologists may help prevent hemorrhage from progressing to adrenal insufficiency and death.