Kyung Ae Lee1, Heung Yong Jin2. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University, Medical School, Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University, Medical School, Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea. mdjinhy@jbnu.ac.kr.
Abstract
OBJECTIVES: Herein, we report a case of rupture of nonfunctional adrenal adenoma treated by nonsurgical supportive management due to high risk for operation. METHOD AND CASE: A patient with end stage renal disease (ESRD) who was on hemodialysis visited our emergency room and complained of a sudden abdominal pain after a fall. A retroperitoneal hemorrhage with hematoma formation around the adrenal adenoma, which was caused by rupture of the adrenal adenoma, was detected by abdominal computed tomography (CT). RESULTS: Supportive management was performed, with serial CT follow-up instead of surgical adrenalectomy treatment because of high operative risk, due to hemodialysis. After 1 week, the patient's vital signs stabilized and the patient did not further complain about abdominal symptoms. However, supportive embolization was performed and the size of hematoma was more decreased. CONCLUSION: We report a case of a patient on hemodialysis who experienced a rupture of a nonfunctioning adrenal adenoma, which was caused by low-energy trauma. The patient's conditions improved with nonsurgical supportive management including embolization.
OBJECTIVES: Herein, we report a case of rupture of nonfunctional adrenal adenoma treated by nonsurgical supportive management due to high risk for operation. METHOD AND CASE: A patient with end stage renal disease (ESRD) who was on hemodialysis visited our emergency room and complained of a sudden abdominal pain after a fall. A retroperitoneal hemorrhage with hematoma formation around the adrenal adenoma, which was caused by rupture of the adrenal adenoma, was detected by abdominal computed tomography (CT). RESULTS: Supportive management was performed, with serial CT follow-up instead of surgical adrenalectomy treatment because of high operative risk, due to hemodialysis. After 1 week, the patient's vital signs stabilized and the patient did not further complain about abdominal symptoms. However, supportive embolization was performed and the size of hematoma was more decreased. CONCLUSION: We report a case of a patient on hemodialysis who experienced a rupture of a nonfunctioning adrenal adenoma, which was caused by low-energy trauma. The patient's conditions improved with nonsurgical supportive management including embolization.
Authors: Vanessa W S Ng; Ronald C W Ma; Wing-Yee So; Kai Chow Choi; Alice P S Kong; Clive S Cockram; Chun-Chung Chow Journal: Arch Intern Med Date: 2010-12-13
Authors: Jin Ook Chung; Dong Hyeok Cho; Jae Hyuk Lee; Dong Deuk Kwon; Dong Jin Chung; Min Young Chung Journal: Yonsei Med J Date: 2010-11 Impact factor: 2.759