CHARACTERISTIC OF ADRENAL HEMORRHAGE. ONE CLINICAL SINGLE EXPERIENCE siavashfeiz@gmail.com

PW06-11

CHARACTERISTIC OF ADRENAL HEMORRHAGE. ONE CLINICAL SINGLE EXPERIENCE

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Poland

Oral or Poster

Adrenal hemorrhage is a very rare and potentially life threatening disease, which may be secondary to the trauma or of an non-traumatic etiology.

Between 2012 and 2022, a total of 649 adrenalectomies were performed in the studied department, including 605 laparoscopic and 44 open procedures. In 199 cases, adrenal hemorrhage (AH) was confirmed postoperatively, with 39 cases diagnosed preoperatively through imaging. The type of surgery was determined by tumor size and hemorrhage characteristics rather than by AH itself.

Among the 199 patients (127 women, 72 men), two subgroups were identified: 39 patients experienced acute symptoms such as flank or back pain, while 160 showed incidental findings of hemorrhage. Pheochromocytoma and adrenal cortical carcinoma (ACC) significantly elevated bleeding risk, especially in lesions over 54 mm. Laparoscopic surgery was predominantly performed for smaller tumors and demonstrated effective outcomes. Larger tumors and those with hemorrhage complexities more often required open surgery. Importantly, no surgery-related mortality was reported across these groups.

Bleeding into adrenal tumors is still an insufficiently understood topic due to its unpredictability. Out of 199 patients, only 30% (n=39) were prepared for surgery with a preoperative diagnosis of AH, and most of them are pheochromocytoma. The average size of the tumour with preoperative diagnosis of the AH is 7 cm. We suggest that is very important to prepare patients with preoperative diagnosis of AH to surgery using α-adrenoreceptor antagonists. Prolongation of the diagnostic process (time between the imaging examination and the surgery) may result in the disease progression and adrenal bleeding.