Inferior vena cava thrombosis: a mechanism of posttraumatic adrenal hemorrhage.
Inferior vena cava thrombosis: a mechanism of posttraumatic adrenal hemorrhage.
复制标题
下腔静脉血栓形成：创伤后肾上腺出血的机制。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
Aashish Dadarwala
中科院分区：
文献类型：
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作者：
Clay R. Hinrichs;Amy Singer;Pierre D. Maldjian;Hani H. Abujudeh;Aashish Dadarwala
外伤性肾上腺出血是一种罕见的CT表现。在1120例因腹部钝性创伤接受CT检查的成年患者中，Burks等人发现20例（2%）患者肾上腺出血。在儿童创伤人群中，Sivit等人回顾了1155例CT检查，发现34例（3%）患者肾上腺出血。大约85%的外伤性肾上腺出血发生在右肾上腺[1-4]。在文献中发现的几个病例中，下腔静脉血栓形成合并肾上腺出血[1,5]。然而，因果关系尚未明确确立。有人认为下腔静脉血栓和肾上腺出血都是邻近器官直接压迫所致[1,5]。相反，我们提出的情况下，下腔静脉血栓被发现在肾上腺出血前的肾上下腔静脉。我们的病例提示外伤性下腔静脉血栓形成引起的流出梗阻可能是外伤性肾上腺出血的机制之一。
357 osttraumatic adrenal hemorrhage is an uncommon finding on CT. In a series of 1120 adult patients who underwent CT for blunt abdominal trauma, Burks et al. [1] found adrenal hemorrhage in 20 patients (2%). In the pediatric trauma population, Sivit et al. [2] reviewed 1155 CT examinations and found adrenal hemorrhage in 34 patients (3%). Approximately 85% of traumarelated adrenal hemorrhages occur in the right adrenal gland [1–4]. In several cases found in the literature, inferior vena cava thrombosis was seen concurrently with adrenal hemorrhage [1, 5]. However, a cause-and-effect relationship has not been clearly established. It was suggested that the inferior vena cava thrombus and adrenal hemorrhage both result from direct compression by adjacent organs [1, 5]. In contrast, we present a case in which inferior vena cava thrombus was detected in the suprarenal inferior vena cava before an adrenal hemorrhage. Our case suggests that outflow obstruction caused by traumatic inferior vena cava thrombosis may be a mechanism of posttraumatic adrenal hemorrhage.