Ruptured adrenal artery aneurysm: a case report

“…1 There have been six previously reported cases of adrenal artery aneurysms. [1][2][3][4][5][6] While the exact cause of visceral artery aneurysms is not known, atherosclerosis, trauma, inflammatory, and congenital causes may all play a role. The most commonly affected group is young pregnant women.…”

Section: Discussionmentioning

confidence: 98%

“…[1][2][3][4][5][6] Endovascular techniques were used for diagnosis in each of the six previously reported cases of adrenal artery aneurysms, and were also successfully used for treatment in four of the six cases. [1][2][3][4][5][6] In one case, the aneurysm was unable to be treated with an endovascular approach, and an open surgical repair was required. 1 The sixth reported patient was treated with an open ligation without an attempted endovascular repair.…”

Section: Discussionmentioning

confidence: 98%

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Adrenal artery aneurysm encountered during laparoscopic adrenalectomy for pheochromocytoma

Glocker

Ruan

Gillespie

et al. 2011

Journal of Vascular Surgery

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“…Only three cases of adrenal artery aneurysm rupture have been described. Two were in elderly men and involved the inferior adrenal artery 7,8 . The third affected a 27 year old, para 1, post‐date woman who presented with increasing right flank pain and an abnormal cardiotocograph and was delivered by caesarean section for presumed abruption.…”

Section: Discussionmentioning

confidence: 99%

Adrenal artery rupture in pregnancy

Christie

Batool

Moss

et al. 2004

BJOG

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A 32 year old primipara, at 39 þ 2 weeks, presented to labour ward, with left sided chest pain and shortness of breath. She was mildly hypotensive, tachycardic, dyspnoeic and extremely tender over the left side of her abdomen. There was no evidence of vaginal bleeding or uterine activity but fetal bradycardia was detected. It was presumed to be a major placental abruption. The patient was resuscitated with colloids and taken to theatre for immediate caesarean section.A live female, weighing 3.12 kg, was delivered with Apgar scores of 3 at 1 minute and 6 at 5 minutes. Cord bloods indicated a significant fetal acidosis (venous pH 6.77, BE À21.3, arterial pH 6.73, BE À24.0). The placenta had a succenturiate lobe but there was no retroplacental clot or evidence of haemorrhage. Her oxygen saturations remained stable throughout the anaesthetic state and there were no difficulties with ventilation. Post-operatively, she appeared fully recovered, with normal observations, although she still complained of a mild ache in her left loin. Post-operative electrocardiogram and chest X-ray were normal.One hour following delivery, she became hypotensive and her haemoglobin had fallen to 3.8 g/dL. She was acutely tender in the left loin with abdominal distension and increasing oedema. Abdominal ultrasound demonstrated a large haematoma in the area of the spleen suggesting spontaneous splenic rupture with retroperitoneal haemorrhage.The patient was returned to theatre with a combined surgical and obstetric team. Laparotomy was performed and massive retroperitoneal bleeding demonstrated. The liver, spleen and pelvic organs were confirmed to be normal. One thousand, two hundred and eighty grams of blood clot was removed, but despite extensive examination, no specific bleeding point was identified and the retroperitoneal space was packed with 18 abdominal packs. The bleeding appeared to be controlled and for the first time in several hours, her vital signs stabilised.Two hours following transfer to intensive therapy unit, she became hypotensive, tachycardic, hyperkalaemic and developed a coagulopathy suggesting continued intraabdominal bleeding. Her abdominal distension recurred resulting in abdominal compartment syndrome. She was taken back to theatre but once again no specific bleeding point was visualised. Therefore, the abdomen was repacked and the interventional radiology team was called.Using a right femoral artery approach, a flush aortogram was performed that identified the source of bleeding in the left upper quadrant. Selective angiograms of the splenic and left renal arteries were normal. Super-selective catheterisation of the left middle adrenal artery confirmed this to be the site of haemorrhage. There was no evidence of an aneurysm (Fig. 1a). The vessel was embolised with a 2 by 20 mm fibred platinum coil (Boston Scientific) using a coaxial catheter and haemostasis confirmed. Part of the coil was noted to be lying free in the aortic lumen but overall, the coil was thought to be secure (Fig. 1b). The radiologists felt it...

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Ruptured adrenal artery aneurysm: a case report

Cited by 14 publications

References 9 publications

Adrenal Artery Embolization: Anatomy, Indications, and Technical Considerations

Adrenal Artery Embolization: Anatomy, Indications, and Technical Considerations

Adrenal artery aneurysm encountered during laparoscopic adrenalectomy for pheochromocytoma

Adrenal artery rupture in pregnancy

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