Mellékvesehemorrhagia

Mellékvesehemorrhagia refers to bleeding within or around the adrenal glands. These glands, located atop the kidneys, produce hormones essential for regulating metabolism, immune function, and stress response. Hemorrhage can affect one or both adrenal glands and may range in severity from minor spotting to significant bleeding.

The causes of mellékvesehemorrhagia are varied. Trauma to the abdomen or back, especially severe blunt force injury, is a common culprit. Medical conditions that increase the risk of bleeding, such as disseminated intravascular coagulation (DIC), sepsis, or severe anticoagulant therapy, can also lead to adrenal bleeding. Certain medical procedures, including adrenalectomy or biopsies, may also precipitate hemorrhage. In some cases, particularly in neonates, adrenal hemorrhage can occur spontaneously or be associated with birth complications. Underlying adrenal tumors or cysts can also be prone to bleeding.

Symptoms can be non-specific and depend on the extent of the bleeding and any underlying cause. Acute, severe hemorrhage may present with sudden flank pain, abdominal pain, nausea, vomiting, and signs of shock, such as low blood pressure and rapid heart rate. Chronic or less severe bleeding might manifest as vague abdominal discomfort, fatigue, or symptoms related to adrenal insufficiency if a significant portion of the adrenal gland is damaged.

Diagnosis typically involves imaging studies. Ultrasound is often used, especially in infants, while CT scans are more sensitive for detecting hemorrhage in adults and can help identify the extent and potential cause. MRI may also be utilized. Blood tests are important to assess hormone levels, check for signs of infection or clotting disorders, and monitor for adrenal insufficiency.

Treatment depends on the underlying cause and the severity of the bleeding. Mild cases may resolve spontaneously with conservative management. More significant bleeding may require blood transfusions, correction of coagulopathies, and treatment of any underlying infection or condition. In rare, life-threatening situations, surgical intervention to control bleeding might be necessary. Management also includes monitoring and supportive care for potential adrenal insufficiency.