A Rare Condition: Nonhemorrhagic Infarct of Adrenal Gland in Pregnancy

Adrenal infarction can be hemorrhagic or non-hemorrhagic, while the latter is much less common. Non-hemorrhagic adrenal infarction (NHAI) is a rare but potentially serious cause of acute abdominal pain in pregnancy that can lead to significant adverse outcomes for both mother and baby if not treated promptly and appropriately. Diagnosis of this condition is challenging due to the non-specific nature of clinical and laboratory findings. Ultrasound (US) has limited utility in diagnosing retroperitoneal pathology, while the use of computed tomography (CT) is restricted due to concerns about fetal radiation exposure. Diagnosis is typically based on magnetic resonance imaging (MRI) findings, with other potential etiological causes of abdominal pain being systematically ruled out. Treatment primarily consists of analgesics and anticoagulants. In this case report, we present a pregnant patient who arrived at the emergency department with an acute abdomen. Various MR images are provided, illustrating the diagnostic process. The patient was successfully treated with anticoagulants and antibiotherapy. Through this case, we aim to highlight the role of imaging in the differential diagnosis, management, and follow-up of pregnant patients presenting with acute abdominal conditions.