Official websites use. Share sensitive information only on official, secure websites. For commercial re-use, please contact journals. Disclosure: M. Antony: None. Gundlapally: None. Russell: None. Storm: None. Patel: None. Verma: None. Kant: None. It can also be seen in severe stressful situations such as septicemia and extensive thermal burns due to sudden and profound adrenocortical stimulation by endogenous ACTH.
Idiopathic spontaneous adrenal hemorrhage and motor vehicle accident induced adrenal hemorrhage have also been rarely reported. Coagulopathy, thromboembolic disease, and postoperative state are 3 major risk factors associated with bilateral adrenal hemorrhage.
We present a unique case of a patient who presented with bilateral adrenal hemorrhage following deep tissue body massage. Clinical Case: A year-old male with a past medical history of recurrent pulmonary embolism PE and deep venous thrombosis DVT due to lupus anticoagulant disorder status-post inferior vena cava IVC filter and recent change from Coumadin to Xarelto presented to the ED with a chief complaint of right upper quadrant RUQ pain extending to the right flank.
Patient experienced unrelenting pain after a deep-tissue massage one week prior to presentation. He returned after pain worsened, and a repeat CT showed right adrenal hemorrhage and enlargement. Patient denied all other symptoms except pain. PT was elevated at Anticoagulation was stopped for three to four weeks, and nonsurgical management was recommended. Potassium supplementation was given, and the patient was continued on his hypertension medications. On further investigation, origin of the hemorrhage was determined to be traumatic secondary to the massage during which the masseuse walked on the patient.
The patient was discharged after three days but was readmitted after continued abdominal pain and hyponatremia. He was diagnosed with a left-sided adrenal hemorrhage on repeat CT scan twelve days after identification of the first.
