{"id":4322,"date":"2011-12-28T15:00:08","date_gmt":"2011-12-28T20:00:08","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/im-residency\/?p=4322"},"modified":"2011-12-28T15:00:08","modified_gmt":"2011-12-28T20:00:08","slug":"an-unusual-cause-for-abdominal-pain","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/im-residency\/2011\/12\/28\/an-unusual-cause-for-abdominal-pain\/","title":{"rendered":"An Unusual Cause of Abdominal Pain"},"content":{"rendered":"<p>A 69 yo M with pmhx of HTN, atrial fibrillation on warfarin, unspecified hx of thyroid and parathyroid cancers status post resection presents with acute left-sided abdominal pain. Subsequent labs showed a significant drop in hematocrit and imaging showed a large left-sided adrenal hemorrhage. The patient had his anti-coagulation reversed, then was taken to IR-suite for embolization of a sub-branch of his left adrenal artery.<\/p>\n<p>Adrenal hemorrhage is an uncommon condition. When there is significant stress, the adrenal gland becomes edematous and prone to hemorrhage. Epinephrine is a potent thrombogenic factor and with adrenal edema, blood flow can slow leading to adrenal vein thrombosis and hemorrhage.<\/p>\n<p>It is thought \u00a0with several factors that can predispose:<\/p>\n<ul>\n<li>Sepsis and severe illness<\/li>\n<li>Post-operative period<\/li>\n<li>Coagulopathy<\/li>\n<li>Thrombotic Disorders (special attention to Anti-Phospholipid Antibody Syndrome)<\/li>\n<li>Adrenal masses<\/li>\n<li>Systemic Steroid Use<\/li>\n<\/ul>\n<p>Please read this great review from the Mayo Clinic Proceedings about adrenal hemorrhage:<\/p>\n<ul>\n<li><a href=\"http:\/\/www.mayoclinicproceedings.com\/content\/76\/2\/161.short\"><abbr title=\"Mayo Clinic Proceedings\">Mayo Clinic Proceedings<\/abbr>February 2001\u00a0vol. 76\u00a0no. 2\u00a0161-168<\/a> &#8211; Adrenal Hemorrhage: A 25-year Experience at the Mayo Clinic<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>A 69 yo M with pmhx of HTN, atrial fibrillation on warfarin, unspecified hx of thyroid and parathyroid cancers status post resection presents with acute left-sided abdominal pain. Subsequent labs showed a significant drop in hematocrit and imaging showed a large left-sided adrenal hemorrhage. The patient had his anti-coagulation reversed, then was taken to IR-suite [&hellip;]<\/p>\n","protected":false},"author":4816,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[4854],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts\/4322"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/users\/4816"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/comments?post=4322"}],"version-history":[{"count":0,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/posts\/4322\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/media?parent=4322"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/categories?post=4322"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/im-residency\/wp-json\/wp\/v2\/tags?post=4322"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}