title: Imaging of adrenal and renal hemorrhage.
abstract: Hemorrhage of the kidneys and adrenal glands has many etiologies. In the adrenal glands, trauma, anticoagulation, stress, sepsis, surgery, and neoplasms are common causes of hemorrhage. In the kidneys, reasons for hemorrhage include trauma, bleeding diathesis, vascular diseases, infection, infarction, hemorrhagic cyst rupture, the Antopol-Goldman lesion, and neoplasms. Angiomyolipoma and renal cell carcinoma are the neoplasms most commonly associated with hemorrhage in the kidneys and adrenal cortical carcinoma, metastases, and pheochromocytoma are associated with hemorrhage in the adrenal glands. Understanding the computed tomography and magnetic resonance imaging features, and causes of hemorrhage in the kidneys and adrenal glands is critical. It is also important to keep in mind that mimickers of hemorrhage exist, including lymphoma in both the kidneys and adrenal glands, and melanoma metastases in the adrenal glands. Appropriate imaging follow-up of renal and adrenal hemorrhage should occur to exclude an underlying malignancy as the cause. If there is suspicion for malignancy that cannot be definitively diagnosed on imaging, surgery or biopsy may be warranted. Angiography may be indicated when there is a suspected underlying vascular disease. Unnecessary intervention, such as nephrectomy, may be avoided in patients with benign causes or no underlying disease. Appropriate management is dependent on accurate diagnosis of the cause of renal or adrenal hemorrhage and it is incumbent upon the radiologist to determine the etiology.
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA. nhammond@nmff.org.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hammond
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Antonella
authors.initials: A
authors.lastname: Lostumbo
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Sharon Z
authors.initials: SZ
authors.lastname: Adam
authors.affiliation: Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue-A21, Cleveland, OH, 44195, USA.
authors.forename: Erick M
authors.initials: EM
authors.lastname: Remer
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Nikolaidis
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Vahid
authors.initials: V
authors.lastname: Yaghmai
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Senta M
authors.initials: SM
authors.lastname: Berggruen
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
mesh_terms: D000307:Adrenal Gland Diseases / Q000175:diagnosis* / Q000209:etiology; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000293:injuries; D000792:Angiography; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000293:injuries; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Adrenal; Computed tomography; Hemorrhage; Magnetic resonance imaging; Renal