Anticoagulation-induced unilateral adrenal haemorrhage and pseudoaneurysm

BMJ Case Rep. 2019 Dec 9;12(12):e232539. doi: 10.1136/bcr-2019-232539.

Abstract

Spontaneous unilateral adrenal haemorrhage (AH) is extremely rare. Its presentation is usually non-specific and requires a high degree of suspicion as it is associated with high morbidity and mortality if diagnosis is delayed. Hereby, we present a case of 67-year-old man with significant cardiac history presented with right-sided chest pain and non-specific abdominal pain. He was previously treated for non-ST elevation myocardial infarction 5 days ago prior to the current presentation. CT scan of abdomen and pelvis demonstrated a right-sided active AH. The patient subsequently underwent digital subtraction angiography. Angio-embolisation was attempted for the pseudoaneurysm but failed due to spasm of the vessel. He was managed conservatively and discharged after clinical improvement. Clinic review 6 months later showed significant size reduction of the pseudoaneurysm.

Keywords: adrenal disorders; endocrinology; general surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / chemically induced
  • Abdominal Pain / diagnostic imaging
  • Adrenal Gland Diseases / chemically induced*
  • Adrenal Gland Diseases / diagnostic imaging
  • Aged
  • Aneurysm, False / chemically induced*
  • Aneurysm, False / diagnostic imaging
  • Angiography, Digital Subtraction
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Chest Pain / chemically induced
  • Chest Pain / diagnostic imaging*
  • Conservative Treatment
  • Hemorrhage / chemically induced*
  • Hemorrhage / diagnostic imaging
  • Humans
  • Male
  • Non-ST Elevated Myocardial Infarction / drug therapy*
  • Non-ST Elevated Myocardial Infarction / physiopathology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anticoagulants