Adrenal hemorrhage

Hemorrhage and necrosis of the adrenal gland tissue.

Adrenal gland

Causes

Adrenal hemorrhage can be caused by either traumatic causes or non-traumatic causes. Trauma can be due to injury or surgery to the adrenal glands. Non-traumatic causes include:

• Acute stress
• Antiphosphopipid syndrome (APS)
• Blood thinner medications such as Coumadin / Warfarin or Heparin
• The spontaneous type
• Tumors of the adrenal gland

Symptoms and signs

Symptoms and signs of adrenal crisis can include any of the following:

• Abdominal pain or flank pain
• Confusion, loss of consciousness, or coma
• Dehydration
• Dizziness or lightheadedness
• Fatigue, severe weakness
• Headache
• High fever
• Loss of appetite
• Low blood pressure
• Low blood sugar
• Nausea, vomiting
• Rapid heart rate
• Rapid respiratory rate
• Slow, sluggish movement
• Unusual and excessive sweating on face or palms

Investigations

Tests that may be ordered to help diagnose acute adrenal crisis include:

• ACTH stimulation test or Cosyntropin stimulation test
• Cortisol level
• Blood sugar
• Potassium level
• Sodium level
• pH level
• CT scan
• Ultrasound
• Magnetic resonance imaging

Treatment

• In adrenal crisis, you need to be given the drug hydrocortisone intravenous or intramuscular.
• You may receive intravenous fluids if you have low blood pressure.
• You will need to go to the hospital for treatment and monitoring.
• If infection or another medical problem caused the crisis, you may need additional treatment.

Prognosis

Shock may occur if treatment is not provided early, and it can be life threatening.

Consequences

Bilateral and extensive hemorrhage may lead to acute adrenal insufficiency, shock, and even death.

Also see

• Neonatal adrenal hemorrhage
• Hemorrhage
• Adrenal gland
• Adrenal insufficiency
• Hematoma
• Traumatic injury
• Adrenal crisis

Adrenal hemorrhage Resources
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