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Adrenal glands hemorrhages: embolization in acute setting

  
@article{GS22026,
	author = {Francesco Giurazza and Fabio Corvino and Mattia Silvestre and Gianluca Cangiano and Errico CavagliĆ  and Francesco Amodio and Giuseppe De Magistris and Giulia Frauenfelder and Raffella Niola},
	title = {Adrenal glands hemorrhages: embolization in acute setting},
	journal = {Gland Surgery},
	volume = {8},
	number = {2},
	year = {2018},
	keywords = {},
	abstract = {Background: Acute adrenal hemorrhages are a rare event compared to other abdominal visceral injuries because of the anatomic localization of the adrenal glands; main causes are trauma and ruptured neoplasms. This manuscript reports on a single center experience of transarterial embolizations of adrenal hemorrhages in emergency setting.
Methods: In this retrospective analysis from 2010 to date, 17 patients (12 men and 5 women, mean age: 59.8 years) presenting with adrenal bleedings were treated by endovascular embolization. The etiology was traumatic in 7 cases, ruptured neoplasm in 8 cases and spontaneous in 2 patients assuming oral anticoagulant therapy. After thin slice contrast enhanced CT, a superselective embolization was conducted with different embolizing agents according to the type of vessel lesion and operator preference.
Results: Technical success rate, considered as interruption of adrenal bleeding detectable at angiography, was 94.1%. Clinical success rate, considered as hemodynamic stability restoration within 24 hours from the procedure, was 82.3%. Vessels involved were the superior adrenal artery in 5 patients, the middle adrenal artery in 8 patients, the inferior adrenal artery in one patient and more than one adrenal artery in 3 patients. No procedure-related major complications occurred and no patients had infarctions, necrosis, abscess formation, or required long-term steroid supplementation.
Conclusions: Acute adrenal hemorrhages can be safely and effectively managed by catheter directed embolizations; the source of bleeding has to be carefully investigated at CT and angiography because adrenal glands present with a wide and complex vascular arterial network.},
	url = {http://gs.amegroups.com/article/view/22026}
}