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Spontaneous rupture of an adrenal artery in pregnancy: a case report

Journal Paper/Review - Dec 30, 2012

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Citation
Bolla D, Schyrba V, Drack G, Dietler S, Hornung R. Spontaneous rupture of an adrenal artery in pregnancy: a case report. Case Rep Obstet Gynecol 2012:Article ID 859068.
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Journal Paper/Review (English)
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Case Rep Obstet Gynecol 2012
Publication Date
Dec 30, 2012
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2090-6692
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Article ID 859068
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Brief description/objective

A spontaneous rupture of an adrenal artery is a rare cause of abdominal pain in pregnancy. We present a case of a pregnant woman who needed to be operated on because of a rupture of the right adrenal artery associated with a fetal bradycardia. An immediate caesarean section was performed. The intra-abdominal palpation identified an extensive retroperitoneal mass near the right kidney and a postoperative computer tomography confirmed an active bleeding near the kidney. For this reason our interventional radiology team, using a right femoral artery approach, performed a flush aortogram and identified the source of bleeding in the right adrenal artery. After two attempts, a coiling of the artery stopped the haemorrhage. The pathogenesis of arterial haemorrhage is still poorly understood although a possible cause could be the excess of hormones during pregnancy, which can lead to a significant arterial wall degeneration. In case of a retroperitoneal bleeding and if the patient is still haemodynamically stable, a transcatheter embolization using microcoils must be considered. This technique is nowadays safe and effective and can be performed within a short time with a lower risk of complications.