| Summary: | Xufeng Peng,1,2 Wenqiang Luo,1,2 Xinru Zhang,1,2 Weidong Zhu1,2 1Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China; 2Shanghai Eastern Urological Reconstruction and Repair Institute, Shanghai, China Background: Acute abdominal pain is a common complaint of patients presenting at the emergency department (ED). It can be caused by a broad spectrum of diseases. Providing care for patients with acute abdominal pain requires familiarity with the epidemiology, prevalence, and presentation of abdominal pathology, as well as a working knowledge of the differential diagnoses. Case report: In this article, we discuss a case of spontaneous rupture of adrenal hemangioma with large retroperitoneal hemorrhage in a 31-year-old female. Discussion: Emergency physicians regularly encounter uncommon causes of abdominal pain. Spontaneous rupture of adrenal hemangioma is an extremely rare cause of abdominal pain, but proper understanding of the disease process will aid clinicians to make a final diagnosis and ensure appropriate treatment. In this study, presentations and risk factors for spontaneous, atraumatic rupture of adrenal hemangioma as well as ED management and definitive treatment options are discussed. Keywords: retroperitoneal hemorrhage, flank pain, adrenal hemangioma, spontaneous rupture
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