Flank pain in the third trimester as a clue to diagnose spontaneous adrenal hemorrhage.

Flank pain in pregnancy is a serious complaint and may have several etiologies, such as pyelonephritis or trauma. Spontaneous adrenal hemorrhage is rare in pregnancy, but is life threatening. We report a third-trimester pregnant woman with idiopathic bilateral spontaneous adrenal hemorrhage who presented with acute-onset severe flank pain and developed adrenal insufficiency. Normal blood pressure following hemorrhagic infarction may obscure the underlying adrenal insufficiency.