Bilateral adrenal hemorrhage after colectomy for perforated diverticulitis: A case report

Monzavi, Carlos Amir Esparza; Hamed, Ahmed B.; Nordenstam, Johan; Gantt, Gerald

doi:10.1016/j.ijscr.2020.12.028

Cited by 2 publications

(3 citation statements)

References 17 publications

(7 reference statements)

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“…In published reports of BAH after cholecystectomy, and after partial colectomy for adenocarcinoma, primary antiphospholipid antibody syndrome has been implicated [ 4 , 5 ]. Additionally, BAH has been described after liver abscess drainage and perforated diverticulitis [ 6 , 7 ]. This is the first report of BAH post- Whipple procedure.…”

Section: Discussionmentioning

confidence: 99%

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Andres,

Suchak,

Brady

et al. 2023

Journal of Surgical Case Reports

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The incidence of bilateral adrenal hemorrhage (BAH) in the postoperative setting is rare, but potentially life threatening. A literature review of postoperative BAH reveals that there is limited data on BAH following abdominal surgery. We present a case of BAH following pancreaticoduodenectomy, which has not been previously documented in the literature. A 70-year-old male patient with no previous history of adrenal disease underwent an uncomplicated pancreaticoduodenectomy and was discharged after a typical postoperative course. He was readmitted with abdominal pain and ileus on POD 8 and a computed tomography (CT) scan was initially unremarkable, but a repeat CT scan on POD 11 demonstrated BAH. He was found to have adrenal insufficiency and was successfully treated with steroids. Clinicians should be aware of the possibility of adrenal hemorrhage postoperatively as it can potentially be a fatal surgical complication. To enhance patient outcomes, early detection and appropriate treatment are essential.

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Section: Discussionmentioning

confidence: 99%

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Andres,

Suchak,

Brady

et al. 2023

Journal of Surgical Case Reports

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“…Our patient had bilateral adrenal hemorrhage, severe hyponatremia, confusion, and leucocytosis but no anemia. Postoperative hypotension associated with hyponatremia suggests adrenal insufficiency and should be worked up for adrenal hemorrhage [ 1 ]. Unexplained shock in anticoagulated patients should be worked up for adrenal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…It is a medical emergency and can be fatal. Bilateral adrenal hemorrhage was identified in at least 15% of people who died of shock on autopsy [ 1 ]. The estimated prevalence of primary adrenal insufficiency is between 4-60 per million [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Spontaneous Bilateral Adrenal Hemorrhage Presenting as Hyponatremia

Chippa¹,

Swetha²,

Gujarathi³

et al. 2022

Cureus

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Bilateral adrenal hemorrhage is a very unusual cause of severe adrenal insufficiency and hyponatremia. It can result from trauma, infections, or antiphospholipid antibody syndrome and can be fatal if not diagnosed and treated early. Here, we present a 58-year-old Caucasian man with fatigue, altered sensorium, bradycardia, and hypotension. He denied any abdominal pain, recent trauma, or anti-platelet or anticoagulation agents. His laboratory workup showed hyponatremia with low serum cortisol levels. He was further worked up and underwent computerized tomography (CT) of the abdomen, which showed bilateral adrenal hemorrhage. He was treated with intravenous (IV) steroids followed by oral hydrocortisone and fludrocortisone. His symptoms resolved, and he was safely discharged home. Asymptomatic bilateral adrenal hemorrhage is a sporadic disease, and it should be in the differential diagnosis for disproportionately sick people with other adrenal insufficiency features.

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Bilateral adrenal hemorrhage after colectomy for perforated diverticulitis: A case report

Cited by 2 publications

References 17 publications

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Acute Spontaneous Bilateral Adrenal Hemorrhage Presenting as Hyponatremia

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