11/30. Case report: unusual appearance of a giant adrenal pseudocyst.Adrenal pseudocysts are uncommon lesions which usually present with abdominal discomfort and swelling due to their large size. The computed tomographic appearances typically demonstrate a smooth thin-walled low attenuation mass with peripheral curvilinear calcification. This case demonstrates the unusual appearances of a pseudocyst with multiple central punctate calcifications as a result of repeated haemorrhage. The radiological appearance of this complex mass mimicked an hydatid cyst. The increase in size of the pseudocyst is demonstrated over a 4 year period.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
12/30. Septicaemia and adrenal haemorrhage in congenital asplenia.Five patients developed overwhelming infection as a result of congenital asplenia, which was previously unsuspected in all cases. Each illness followed a fulminant course resulting in death within 24 hours. They illustrate the respective roles of haemophilus influenzae infection (n = 4) and adrenal haemorrhage (n = 4) in this condition. We suggest a management protocol for screening infants with abnormalities of the atria or viscera with splenic ultrasound and examination of a blood film for Howell-Jolly bodies. vaccination and prophylactic antibiotics should be considered for those at risk. Vigorous use of parenteral antibiotics and steroids in suspected infection is recommended.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
13/30. Hypercalcaemia in acute adrenal insufficiency. A case report.A woman aged 62 developed a septic shock and pulmonary embolism after skin grafting for extensive burns. She was put on anticoagulants. A second shock led to renal insufficiency. Hypercalcaemia developed. A CT scan of the upper abdomen disclosed enlarged adrenal glands. An acute adrenal haemorrhage was suspected. The levels of cortisol were low in the plasma and urine and did not respond to ACTH stimulation. cortisone replacement therapy improved the condition of the patient and normalized plasma calcium levels. The mechanisms of hypercalcaemia in acute adrenal insufficiency are discussed. Multiple factors have been proposed: haemoconcentration, an increased affinity of plasma proteins for calcium, an increase in the filtrable calcium complexes, and an enhanced calcium mobilization of skeletal origin.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
14/30. diagnosis and management of neonatal adrenal haemorrhage.Three patients with neonatal adrenal haemorrhage (NAH), presenting with various signs and symptoms, are reported. The role of ultrasonography in diagnosis and management of this entity is emphasized. Conservative management is advocated, once the diagnosis is confirmed. Surgery is indicated only for cases of uncontrollable haemorrhage.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
15/30. Adrenal haemorrhage presenting as an abdominal mass in the newborn.Adrenal haemorrhage in the newborn, an entity well recognized at autopsy and as a cause of massive haemorrhage, may present as an asymptomatic abdominal mass. Three cases of neonatal adrenal haemorrhage are described and the literature is reviewed. Most of the affected babies were of normal birthweight, full term and with no history of difficult delivery or neonatal asphyxia. Most presented with a flank mass and jaundice. The haemoglobin was not always low. Intravenous urography and sonography were the investigations of choice. The most serious condition in the differential diagnosis is neuroblastoma, but the chance of this presenting in the newborn period with normal catecholamine secretion and no evident metastases is sufficiently rare to justify expectant management. Follow-up physical examination and repeat sonography at 1 month are recommended. This interval is long enough to allow resolution of a mass caused by adrenal haemorrhage.- - - - - - - - - - ranking = 8keywords = haemorrhage (Clic here for more details about this article) |
16/30. Cardiac bypass surgery with haemorrhagic endocrine sequelae.Cardiac bypass surgery is associated with changes in haemostatis which can lead to bleeding. This report highlights two examples of such bleeding which led to unusual clinical presentations and endocrinological consequences: adrenal and pituitary haemorrhage.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
17/30. Massive adrenal haemorrhage complicating adrenal neoplasm.Two patients presented to hospital with clinical features of acute retroperitoneal haemorrhage. In each case, laparotomy revealed massive adrenal haemorrhage, and histological evidence of underlying neoplasia was eventually found.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
18/30. Functional significance of idiopathic adrenal calcification in the adult.Two young adults with idiopathic adrenal calcification are described. In one patient the calcification was probably secondary to adrenal haemorrhage in the neonatal period. Neither patient exhibited clinical features suggestive of adrenal cortical insufficiency, and baseline serum cortisol levels were normal. The corticosteroid responses to ACTH administration and to other provocative tests indicated that both glucocorticoid and mineralocorticoid reserve was normal. One patient showed an appropriate epinephrine response to insulin-induced hypoglycaemia. We conclude that even extensive adrenal calcification may be compatible with completely normal adrenal function. Since, however, little is known of the natural history of this condition, lifelong follow-up of such patients is advised.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
19/30. Real time sonographic diagnosis of adrenal haemorrhage.The diagnosis of adrenal haemorrhage in 4 infants using a linear real-time ultrasound scanner is described. The resolution of real-time equipment appears to be sufficient for such a diagnosis and its flexibility is well suited for small babies.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
20/30. Are the clinically important adrenal cysts hamartomas?An adrenal cyst in a 36-year-old apparently healthy woman was diagnosed as a hamartoma with haemangiomatous structures and a large cyst, probably secondary to haemorrhage within the lesion. After reviewing the histological records of all the previously published cases of similar "haemorrhagic" non-inflammatory adrenal cysts, the aetiology of which has been considered unclear, we conclude that they too were probably hamartomas. We therefore propose that this type of adrenal cyst, the only of clinical importance, is aetiologically a hamartoma. These tumours often show super-imposed degenerative post-haemorrhagic changes.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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