Isolated adrenal hematoma presenting as acute right upper quadrant pain

Kalil G. Abdullah, Russell N. Stitzlein, Thomas A. Tallman

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background: Adrenal hematoma is an infrequent occurrence in the setting of adult trauma care. It is typically associated with diffuse abdominal injury, and its presence is commonly correlated with high injury severity and mortality. Objectives: To discuss the recognition of adrenal hematoma as a cause of right upper quadrant pain. Case Report: We present the case of a 23-year-old man who presented to the Emergency Department (ED) with acute right upper quadrant pain after blunt trauma to the area; he was initially diagnosed with an abdominal contusion with an incidental adrenal adenoma. After experiencing continued pain for 2 days, the patient returned to the ED for re-evaluation. Subsequent imaging revealed that the adrenal mass had enlarged, and it was determined that this patient had suffered an acute adrenal hematoma. The lesion was determined to be self-limited and the patient was treated with supportive care. Follow-up images 8 weeks later revealed resolution of the hematoma and the patient reported complete resolution of symptoms. We also discuss adrenal hematoma in the trauma setting and explain that in our patient, given the clinical scenario and statistical evidence, an initial diagnosis of adrenal hematoma should be favored over abdominal contusion with incidental adenoma. Conclusion: We describe a case of a traumatic isolated adrenal hematoma that presents acutely as right upper quadrant pain. This unusual presentation highlights the need for recognition of the adrenal gland as a potential cause of right upper quadrant pain in the trauma setting.

Original languageEnglish (US)
Pages (from-to)e215-e217
JournalJournal of Emergency Medicine
Volume43
Issue number4
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

Keywords

  • abdominal trauma
  • adrenal adenoma
  • adrenal hematoma
  • sports injuries

ASJC Scopus subject areas

  • Emergency Medicine

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