Spontaneous adrenal hemorrhage / 中华泌尿外科杂志

ABSTRACT

Objective To improve the effect of diagnosis and treatment in spontaneous adrenal hemorrhage. Methods Eleven cases of spontaneous adrenal hemorrhage were retrospectively summaried. Results Ten cases manifested lumbago in troubled side and 1 case was detected adrenal masses in operations of carcinoma of ureter.The functions of adrenal gland were all normal.Eleven were checked by ultrasound B of whom 3 cases had cystic masses, and strong echo of point or partition could be detected.Seven cases were manifested with low echo of masses,and 1 case of carcinoma of ureter was normal in ultrasound B before operation.Ten cases were scanned by CT.The focus was oval round shape and the border of focus was detected clearly.The value of CT ranged from 34.7 to 85.0 HU, and in 6 cases their values exceeded 50.0 HU.Among them,fluid plan could be seen in 1 case.Reinforcement CT was performed in 3 cases,and the masses were not reinforced.Three cases were scanned by MRI,and the ununion masses in area of adrenal gland were detected.There was iso signal in T1 weighted,while there was low signal in T2 weighted.Six cases underwent resection of adrenal gland; 5 cases underwent partial resection of adrenal gland and masses.The pathology of post operation were internal hemorrhage of adrenal gland medulla,and the hematoma was coated by the tissue of adrenal gland.The functions of adrenal cortex were all normal with follow up of 0.6 to 8 years. Conclusions The spontaneous adrenal hemorrhage can be diagnosed definitely by ultrasound B,CT and MRI.The symptoms of waist and abdominal pain were very distinctive with adrenal hemorrhage on both sides.The operation should be done when the adrenal hemorrhage is in one side and the hematoma exceeds 5 cm in diameter.Patrial resection of adrenal gland and hematoma should be operated for saving the normal adrenal tissues around the hematoma.