Precocious ischemia preceding bilateral adrenal hemorrhage: A case report

Area of Science:

• Radiology
• Endocrinology
• Medical Imaging

Background:

• Adrenal gland pathologies can present with nonspecific symptoms.
• Early detection of adrenal compromise is crucial for patient management.
• Contrast-enhanced computed tomography (ceCT) is a key imaging modality.

Observation:

• A middle-aged male presented with abdominal pain and reduced adrenal gland perfusion on initial ceCT.
• Clinical and laboratory tests were initially inconclusive for adrenal disease.
• A follow-up ceCT revealed acute bilateral adrenal hemorrhage.

Findings:

• Initial adrenal hypoperfusion on ceCT was a prodromal sign of hemorrhagic adrenal disease.
• The case demonstrates the evolution from hypoperfusion to hemorrhage.
• Imaging plays a critical role in diagnosing uncommon adrenal disorders.

Implications:

• Adrenal hypoperfusion identified via imaging warrants close monitoring for progression.
• Prompt clinical management is essential to address potential aggressive pathological conditions.
• This case underscores the diagnostic value of serial imaging in adrenal medicine.