EURORAD ESR

Case 15109

Traumatic Adrenal Hemorrhage

Author(s)
James McPhail1, Stanton Royer1, Max Mam, MD Gregory Hal Bowers, MD Jayanth H. Keshavamurthy, MD

(1) Senior Medical Student
1120 15th street, BA-1411 30912 Augusta, United States of America; Email:jkeshavamurthy@augusta.edu
 
Patient
male, 21 year(s)
 
 
  • Figure 1
    Axial CT

    Axial CT image demonstrates a moderate to large right adrenal haematoma with areas of active arterial bleeding.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 2
    Coronal CT

    Coronal CT image demonstrates traumatic right adrenal haematoma and complex laceration of the liver. The liver did not show evidence of active arterial bleeding.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 3
    Haemorrhage of the right superior adrenal arteries

    Selective arteriogram of the right inferior phrenic artery revealed active haemorrhage of the right superior adrenal arteries.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 4
    Post-embolisation arteriogram of the right inferior phrenic artery

    Intravascular embolisation coils were deployed in the right inferior phrenic artery. Postembolisation arteriogram demonstrates complete resolution of the haemorrhage of the right superior adrenal arteries.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: Catheter arteriography; Procedure: Embolisation; Special Focus: Trauma;
     
     
  • Figure 5
    Aortogram

    The middle adrenal artery typically originates from the lateral aspect of the aorta but is too small in caliber to be seen on this aortogram.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 6
    Arteriogram of the right renal artery

    The inferior adrenal arteries are seen arising from the adjacent renal artery and do not demonstrate active haemorrhage.

     
    Area of Interest: Adrenals; Trauma; Vascular; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
Axial CT image demonstrates a moderate to large right adrenal haematoma with areas of active arterial bleeding.
 
Coronal CT image demonstrates traumatic right adrenal haematoma and complex laceration of the liver. The liver did not show evidence of active arterial bleeding.
 
Selective arteriogram of the right inferior phrenic artery revealed active haemorrhage of the right superior adrenal arteries.
 
Intravascular embolisation coils were deployed in the right inferior phrenic artery. Postembolisation arteriogram demonstrates complete resolution of the haemorrhage of the right superior adrenal arteries.
 
The middle adrenal artery typically originates from the lateral aspect of the aorta but is too small in caliber to be seen on this aortogram.
 
The inferior adrenal arteries are seen arising from the adjacent renal artery and do not demonstrate active haemorrhage.
 
 
 
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