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- W2103264466 abstract "Spontaneous massive retroperitoneal hemorrhage from an adrenal gland is an extremely rare event and is usually fatal if unrecognized. We report a case of this critical event occurring in a young woman affected by a silent adrenocortical carcinoma in the postpartum period. CASE REPORT A 39-year-old lactating woman in the eighth month of puerperium presented with sudden onset of left abdominal pain and signs of shock. Computerized tomography (CT) showed a large (12 8 cm) hematoma in the retroperitoneal space around the left kidney and extending from the diaphragm throughout the pararenal space along the entire course of the psoas muscle (fig. 1). The left adrenal gland was not visible in all CT images, so the adrenal origin of the hemorrhage was suspected. The patient was placed under general anesthesia and a chevron incision was made. At surgical abdominal exploration a large hematoma was found in the retroperitoneum arising from a left adrenal gland tumor. Left adrenalectomy with preservation of the left kidney and drainage of the retroperitoneal hematoma were performed. To stabilize blood pressure during the operation 6 units blood was transfused and volume supplementation was performed. Hematoma volume was approximately 1,500 gm and operative time was 180 minutes. Pathological diagnosis was surprisingly a primary highly aggressive adrenocortical carcinoma (fig. 2). The postoperative period was uneventful and blood pressure normalized without medication. There was no sign of endocrine dysfunction. Control total body CT and bone scintigraphy were negative for metastatic lesions. The patient subsequently underwent chemotherapy evaluation and was started on mitotane. DISCUSSION" @default.
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- W2103264466 date "2003-11-01" @default.
- W2103264466 modified "2023-09-23" @default.
- W2103264466 title "Spontaneous Rupture of Adrenal Carcinoma During the Puerperal Period" @default.
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- W2103264466 doi "https://doi.org/10.1097/01.ju.0000089501.33467.8e" @default.
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