Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

Valverde, Francisco Miguel González; Balsalobre, María; Torregrosa, N.; Molto, M.; Silva-Ramos, Miguel; Rojas, José Luis Vázquez

doi:10.1007/s00270-006-0029-4

Cited by 13 publications

(13 citation statements)

References 10 publications

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“…Local or systemic conditions impacting the retroperitoneal organs or blood vessels can result in spontaneous retroperitoneal hemorrhage. Examples of such conditions include benign or malignant tumors of the kidney or adrenal gland (Brodey et al, 1982;Tappe et al, 1997), hemangioma (González-Valverde et al, 2007), vascular malformation, thrombosis, pancreatitis or pancreatic cancer, the use of anticoagulants and antiplatelet drugs (Melde, 2003;Otrock et al, 2006;Daliakopoulos et al, 2008), hemophilia, and leukemia (Vayá et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

Fan

Deng

Liu

et al. 2012

J. Zhejiang Univ. Sci. B

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Abstract:In this paper, we described the symptoms and treatment of a patient with diabetic nephropathy accompanied by spontaneous retroperitoneal hemorrhage after hemodialysis. An elderly female patient with diabetic nephropathy presented with severe pain, numbness, and an increasing swelling in the left hip and left thigh after six sessions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent. Her hemoglobin decreased to 46 g/L. An abdominal ultrasound showed a hematoma in the left retroperitoneal space, and computed tomography (CT) findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle. After aggressive supportive therapy [the administration of packed red blood cell transfusion, carbazochrome sodium sulfonate injection, and continuous venovenous hemofiltration (CVVH)], the patient's vital signs stabilized and her hemoglobin increased to 86 g/L. Repeat CT showed that the hematoma had been partially absorbed after two weeks. Eventually, the patient was discharged with stable vital signs. Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage, particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.

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Section: Introductionmentioning

confidence: 99%

Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

Fan

Deng

Liu

et al. 2012

J. Zhejiang Univ. Sci. B

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“…[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%

“…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%

Adrenal artery aneurysm encountered during laparoscopic adrenalectomy for pheochromocytoma

Glocker

Ruan

Gillespie

et al. 2011

Journal of Vascular Surgery

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“…One hundred ninety-nine VVA cases have been published, with the portal venous system accounting for over 95% of these reported occurrences [2, 3]. Our literature search revealed a limited number of aneurysms arising in the adrenal vasculature, with only 11 cases previously reported and all occurring in the adrenal artery [4–14]. To the best of our knowledge, this is the first report of an aneurysmal formation arising from the venous vasculature of the adrenal gland and the first case of an adrenal vasculature anomaly in a patient with hemophilia A.…”

Section: Discussionmentioning

confidence: 99%

“…Recognized medical risk factors predisposing to aneurysm development include tobacco use, atherosclerosis, congenital malformations, connective tissue disorders, autoimmune mechanisms, local inflammatory conditions, infections, primary arterial injury/trauma, vasculitis, medial fibrodysplasia, hypertension, and pregnancy [4]. The most concerning and life-threatening sequelae are rupture and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Massive adrenal vein aneurysm mimicking an adrenal tumor in a patient with hemophilia A: a case report and review of the literature

Wahlmeier¹,

Carson²,

Drincic³

et al. 2016

J Med Case Reports

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BackgroundVisceral venous aneurysms are exceedingly rare, and until now, there have been no reports of this phenomenon in the adrenal vasculature. This report details the first adrenal venous aneurysm reported in the literature. The aneurysm presented as an 18-cm mass that was initially suspected to be a hematoma or tumor on the basis of the complex medical history of the patient, which included hemophilia A and testicular cancer. After surgical excision, pathologic examination confirmed this mass to be a 15.9-cm adrenal vein aneurysm, the largest aneurysm of any type or location recorded in the medical literature.Case presentationA 58-year-old caucasian male with hemophilia A presented to the emergency room of another institution with abdominal pain, blood in the stool, and a history of diverticulosis and symptomatic hemorrhoids. A large, left-sided adrenal mass was detected by computed tomography, and because of the patient’s hemophilia A and imaging consistent with a hemorrhagic mass, a hematoma was initially suspected. The patient was transferred to our institution, monitored for further bleeding with a stable hospital course, and discharged from the hospital under close monitoring. After 7–8 weeks with no change in the size of the mass, concerns grew regarding increasing symptoms of both satiety and mass effects from the large anomaly, as well as about the patient’s complicated medical history, which also included cancer. Surgical excision was recommended because of the concerns about increasing symptoms and the possibility of a malignancy. Correction and maintenance of factor VIII levels were incorporated pre-, intra-, and postoperatively, and en bloc surgical resection was performed to minimize bleeding and provide oncologic extirpation of the mass. A bowling ball-sized mass was removed, and careful pathologic examination revealed the mass to be a venous adrenal aneurysm. After a brief hospital stay, the patient made a full recovery. Extensive review of the literature revealed 11 reports of adrenal artery aneurysms but no reported case of an adrenal aneurysm arising from the venous system.ConclusionsSeveral case reports suggest a correlation between hemophilia and aneurysms. In patients with inherited clotting disorders such as hemophilia A, aneurysms may present in atypical fashions and should be carefully ruled out.

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Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

Cited by 13 publications

References 10 publications

Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

Adrenal artery aneurysm encountered during laparoscopic adrenalectomy for pheochromocytoma

Massive adrenal vein aneurysm mimicking an adrenal tumor in a patient with hemophilia A: a case report and review of the literature

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