Spontaneous Rupture of an Adrenal Artery in Pregnancy: A Case Report. (30th December 2012)

• Record Type: Journal Article
• Authors: Bolla, D.; Schyrba, V.; Drack, G.; Dietler, S.; Hornung, R.
• Other Names: Diejomaoh M. F. Academic Editor.; Ficicioglu C. Academic Editor.
• Is Part Of: Case reports in obstetrics and gynecology. Volume 2012(2012)
• Publication Date: 2012-12-30
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; Obstetrics; Gynecology; Genital Diseases, Female; Generative organs, Female -- Diseases; Gynecology; Obstetrics; Electronic journals; Periodicals; Periodicals; 618
• DOI: 10.1155/2012/859068
• Languages: English
• ISSNs: 2090-6684

Abstract

Abstract : 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.