[Hemorrhagic adrenal pseudocyst: case report].
BACKGROUND
Adrenal cysts are usually asymptomatic; they are usually identified occasionally during ultrasound or C.T. scans (incidentaloma). Among adrenal cysts the most common types are epithelial cysts and pseudocysts. Intracystic haemorrhage is one of the possible complications of adrenal pseudocysts.


METHODS
We report a case of a young woman with right superior abdominal pain, fever and acute anemia. A C.T. scan showed a 10 cm. mass between the liver and the right kidney. To be sure of the nature of this mass also M.R., urography and C.T.-guided biopsy were carried out. This latter only let us make the final diagnosis of hemorrhagic adrenal pseudocyst. Thereafter, a laparotomic right adrenalectomy was performed, with full recovery of the patient.


CONCLUSIONS
Adrenal cysts may cause differential diagnostic problems with masses of contiguous organs like kidney, liver and gallbladder. For this reason, ultrasound and C.T. scans may not be sufficient and must be completed by M.R., urography and/or C.T.-guided biopsy. Intracystic hamorrhage, spontaneous or post-traumatic, may cause to the patient acute anemia which, as soon as the diagnosis is confirmed, indicates surgery. The operation usually is a laparotomic adrenalectomy, since the laparoscopic approach is not sufficient to control large masses with active bleeding inside.
Basile
G
G
Ospedale Vittorio Emanuele, Catania, Dipartimento di Chirurgia-Sezione di Chirurgia d'Urgenza e Generale, Unità Operativa di Chirurgia d'Urgenza.
Buffone
A
A
Cicciarella
G
G
di Mari
P
P
Cirino
E
E
D015746:Abdominal Pain / Q000209:etiology; D000307:Adrenal Gland Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000740:Anemia / Q000209:etiology; D003560:Cysts / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014567:Urography