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Case Reports
. 2023 Jul 31;2023(7):rjad411.
doi: 10.1093/jscr/rjad411. eCollection 2023 Jul.

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Sarah Andres  1 , Nikki Suchak  2 , Maureen Brady  3 , Moshim Kukar  3 , Joy Sarkar  3
Affiliations
Case Reports

Bilateral adrenal hemorrhage after pancreaticoduodenectomy

Sarah Andres et al. J Surg Case Rep. .

Abstract

The incidence of bilateral adrenal hemorrhage (BAH) in the postoperative setting is rare, but potentially life threatening. A literature review of postoperative BAH reveals that there is limited data on BAH following abdominal surgery. We present a case of BAH following pancreaticoduodenectomy, which has not been previously documented in the literature. A 70-year-old male patient with no previous history of adrenal disease underwent an uncomplicated pancreaticoduodenectomy and was discharged after a typical postoperative course. He was readmitted with abdominal pain and ileus on POD 8 and a computed tomography (CT) scan was initially unremarkable, but a repeat CT scan on POD 11 demonstrated BAH. He was found to have adrenal insufficiency and was successfully treated with steroids. Clinicians should be aware of the possibility of adrenal hemorrhage postoperatively as it can potentially be a fatal surgical complication. To enhance patient outcomes, early detection and appropriate treatment are essential.

Keywords: Whipple; adrenal insufficiency; bilateral adrenal hemorrhage; pancreaticoduodenectomy; postoperative.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Axial CT abdomen/pelvis on POD 11 demonstrating the left adrenal gland (white arrowhead) with a high density 2.6 × 2.6 cm fluid collection; density is consistent with a subacute bleed. The right adrenal gland (white arrow) demonstrates thickening suggesting a small hemorrhage, less pronounced than the left.
See this image and copyright information in PMC

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