Recovery of Adrenal Function after Failure Resulting from Traumatic Bilateral Adrenal Hemorrhages
Authors: Barbara Feuerstein, David H.P. Streeten
Journal: Annals of Internal Medicine (1991)

Brief Reports15 November 1991Recovery of Adrenal Function after Failure Resulting from Traumatic Bilateral Adrenal HemorrhagesBarbara Feuerstein, MD, David H.P. Streeten, MB, DPhilBarbara Feuerstein, MD, David H.P. Streeten, MB, DPhilAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-10-785 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMassive bilateral adrenal hemorrhage causing adrenal insufficiency, shock, and death has been recognized at autopsy for many years. Such hemorrhages may result from acute meningococcal and other bacterial septicemias (especially in children), thromboembolic disease, the therapeutic use of anticoagulants, surgical and other forms of "stress," and severe trauma (1-6). The autopsy results from 5 of 60 patients who died after closed thoracic, abdominal, or pelvic injuries, showed bilateral adrenal hemorrhages. Severe bilateral hemorrhages have usually been fatal if they were unrecognized and untreated (7). Adrenal insufficiency in survivors has usually been permanent and has required continued steroid-replacement therapy (4). We...References1. Amador E. Adrenal hemorrhage during anticoagulant therapy. A clinical and pathological study of ten cases. Ann Intern Med. 1965;63:559-571. LinkGoogle Scholar2. Clark O. Postoperative adrenal hemorrhage. Ann Surg. 1975;182:124-9. CrossrefMedlineGoogle Scholar3. Anderson K, Kuhajda F, and Bell W. Diagnosis and treatment of anticoagulant-related adrenal hemorrhage. Am J Hematol. 1981;11:379-85. CrossrefMedlineGoogle Scholar4. Rao R, Vagnucci A, and Amico J. Bilateral massive adrenal hemorrhage: early recognition and treatment. Ann Intern Med. 1989;110:227-35. LinkGoogle Scholar5. Siu S, Kitzman D, Sheedy P, and Northcutt R. Adrenal insufficiency from bilateral adrenal hemorrhage. Mayo Clin Proc. 1990;65:664-70. CrossrefMedlineGoogle Scholar6. Sevitt S. 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Author, Article, and Disclosure InformationAuthors: Barbara Feuerstein, MD; David H.P. Streeten, MB, DPhilFrom the State University of New York Health Science Center, Syracuse, New York. For current author addresses, see end of text. 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