Idiopathic Bilateral Adrenal Haemorrhage in an Otherwise Healthy Patient

Abstract

This is the case of a lady with a bilateral adrenal haemorrhage with no known cause. She presented with abdominal pain that progressed to back pain with rising serum lactate. The initial and repeat computerized tomography (CT) scans were unremarkable apart from small bilateral renal stones. She was ultimately treated conservatively in the hospital and discharged. On a follow-up appointment and CT scan, it was discovered that she had small bilateral adrenal haemorrhages. She was followed in the clinic until symptomatic resolution which did eventuate, and she was subsequently discharged. The case highlights that with no antecedent factors or past medical history combined with no hemodynamic instability, bilateral adrenal haemorrhages would be a diagnosis to reach but should remain in the differential.

Keywords: abdominal pain differential diagnosis; adrenal haemorrhage; bilateral adrenal haemorrhage; conservative management; idiopathic adrenal haemorrhage.

Figure 1. Axial view of CT scan and the bilateral adrenal hemorrhages