Endocrine Abstracts

Introduction: Adrenal haemorrhage is rare. There is a broad spectrum of clinical presentation and aetiology of the condition making it challenging to diagnose. Endocrine dysfunction frequently complicates cases of adrenal haemorrhage. Failure to recognise the condition or its complications can lead to devastating consequences for the patient.

Methods: All patients referred to our centre with adrenal haemorrhage between 2004 and 2014 were included in this retrospective study. The clinical notes, laboratory & radiological investigations of each case were recorded.

Results: Ten patients with adrenal haemorrhage were identified. Seven patients presented with acute abdominal pain. Adrenal haemorrhage was an incidental histological finding in two patients and an incidental radiological finding in one patient. Three of ten patients were diagnosed with hypoadrenalism. Six of ten patients underwent elective adrenalectomy following haemodynamic stabilisation with no associated operative mortality.

Conclusion: The aetiology of adrenal haemorrhage is variable and identifying the underlying diagnosis can be challenging. The appropriate management of the condition requires an awareness of the potential endocrinological consequences of adrenal dysfunction including glucocorticoid deficiency and catecholamine hypersecretion. In our centre elective adrenalectomy following endocrine investigations and haemodynamic stabilisation rather than emergency adrenalectomy is preferred. In this series there was no operative mortality associated with this approach, which is recognised as being elevated in patients operated on acutely for adrenal haemorrhage.