Imaging of adrenal and renal hemorrhage

Nancy Ayers Hammond*, Antonella Lostumbo, Sharon Z. Adam, Erick M. Remer, Paul Nikolaidis, Vahid Yaghmai, Senta Berggruen, Frank H Miller

*Corresponding author for this work

Research output: Contribution to journalReview article

18 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2747-2760
Number of pages14
JournalAbdominal Imaging
Volume40
Issue number7
DOIs
StatePublished - Oct 29 2015

Keywords

  • Adrenal
  • Computed tomography
  • Hemorrhage
  • Magnetic resonance imaging
  • Renal

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Medicine(all)
  • Radiology Nuclear Medicine and imaging
  • Urology
  • Gastroenterology

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