[Bilateral adrenal gland hemorrhage after anterior deep rectum resection. Case report with review of the literature].
Adrenal insufficiency due to bilateral adrenal hemorrhage is a rare but potentially life-threatening postoperative complication. The difficulty lies in making a timely diagnosis, as the symptoms are often unspecific and similar to those presented by other, more common postoperative complications. We report the case of a 71-year-old patient presenting bilateral adrenal hemorrhage following an otherwise uncomplicated low anterior rectum resection for a villous adenoma of the middle rectum.


CONCLUSIONS
In cases of unexplained postoperative deterioration, surgeons should be aware of acute adrenal insufficiency due to bilateral adrenal hemorrhage. With a high index of suspicion the diagnosis is made easily by CT scan and serum-cortisol measurements and prompt steroid replacement can help to avoid a deleterious outcome.
Scheiwiller
A
A
Clinique et Policlinique de Chirurgie Digestive, Hôpitaux Universitaires de Genève, Rue Micheli-du-Crest 24, 1211 Genève 14, Schweiz. andreas.scheiwiller@hcuge.ch
Morel
Ph
P
Soravia
C
C
D018253:Adenoma, Villous / Q000601:surgery*; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000209:etiology*; D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D006854:Hydrocortisone