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Spontaneous idiopathic bilateral adrenal haemorrhage: a rare cause of abdominal pain
Journal article   Open access   Peer reviewed

Spontaneous idiopathic bilateral adrenal haemorrhage: a rare cause of abdominal pain

Salik Nazir, Surendra Sivarajah, Valena Fiscus and Eugene York
BMJ case reports, v 2016, pbcr2016215452
10 May 2016
PMID: 27166002
url
https://europepmc.org/articles/pmc4885497View
Published, Version of Record (VoR)Open Access (License Unspecified) Open

Abstract

We describe a case of a 62-year-old woman with a history of chronic obstructive pulmonary disease and gastro-oesophageal reflux disease who presented to the emergency department with left lower quadrant abdominal pain, flank pain with nausea and no history of preceding trauma. The patient had finished a course of azithromycin and oral methylprednisolone 1 day prior to presentation. Abdominal and pelvic CT scan identified changes suggestive of bilateral adrenal haemorrhage. The patient did not show signs of acute adrenal insufficiency but was started on steroid replacement therapy because of concerns about possible disease progression. All recognised causes of adrenal haemorrhage were excluded suggesting this was a case of spontaneous idiopathic bilateral adrenal haemorrhage, a rarely reported phenomenon in the literature. The patient was discharged after clinical improvement following 6 days in hospital, taking oral steroid replacement.

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