Failure to ablate the adrenal gland by injection of contrast material

Five attempts were made in 4 patients to infarct an adrenal gland containing an aldosterone-producing tumor, using vigorous retrograde injections of contrast material into the adrenal vein. Although a modest amount of tumor staining was attained in 3 patients, no clinical or laboratory changes were seen. Contrast extravasation appears to be a transient and benign complication. Adrenal vein thrombosis is probably responsible for the reported adrenal infarctions but can be prevented by systemic anticoagulation. The authors conclude that adrenal venography is a safe procedure whose potential risks are far outweighed by the decreased surgical complications when a functional adrenal tumor is accurately located preoperatively.