Bilateral Spontaneous Adrenal Hematoma: Diagnostic Difficulty of Adrenal Insufficiency (Pages 53-55)

Diarra Martin1, Matali Suzanne1, El Ouahabi Hanane1 and Ajdi Farida1,2
1Department of Endocrinology, Diabetology and Nutrition, University Hospital of Fez, Morocco; 2Science Team Medicines – Medical Center of Biomedical and Translational Research. Faculty of Medicine and Pharmacy, University of Fez, Morocco

DOI: http://dx.doi.org/10.12970/2310-9971.2015.03.03.1

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Abstract: Spontaneous bilateral adrenal hematoma is a rare affection with diverse etiologies and can lead to adrenal insufficiency with life-threatening consequences in the absence of immediate and proper management. The clinical manifestation varies depending on the gravity of the hemorrhage. In most cases, there are no specific signs of adrenal insufficiency; and the diagnosis is made by an incidental finding on an imaging made for another reason. Through this paper, we wish to draw the attention of medical practitioners and endocrinologists on the diagnostic and therapeutic approaches to this seemingly uncommon but potentially life-threatening condition. We illustrate this through a case report of a Moroccan patient – who fully consented to this study – and then propose a decision tree. The diagnosis of adrenal insufficiency complicating a bilateral adrenal hemorrhage was thus retained. Bilateral adrenal hematoma has diverse causes. The prevalence and severity of bilateral adrenal hematomas (BAH) are not be neglected. Be it spontaneous or caused clotting disorder, BAH can lead to adrenal insufficiency, with life-threatening consequences if left unattended to.
Computed tomography (CT) scan and magnetic resonance imaging (MRI) are the best imaging techniques for diagnosis. Medical management should be preferred in the absence of acute abdomen or life-threatening condition.

Keywords: Computed, Tomography, Abdominal, Adrenal, Insufficiency.
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