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Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review

Adrenal necrosis is a rare but serious cause of abdominal pain of thrombotic origin during pregnancy. There is often a delay in diagnosis and treatment. The objective was to specify the clinical and paraclinical signs suggestive of adrenal necrosis, making it possible to improve the delay in diagnos...

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Autores principales: Guyon, Mathilde, Degez, Manon, Artifoni, Mathieu, Goronflot, Thomas, Misbert, Emilie, Dochez, Vincent, Winer, Norbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531684/
https://www.ncbi.nlm.nih.gov/pubmed/37762978
http://dx.doi.org/10.3390/jcm12186036
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author Guyon, Mathilde
Degez, Manon
Artifoni, Mathieu
Goronflot, Thomas
Misbert, Emilie
Dochez, Vincent
Winer, Norbert
author_facet Guyon, Mathilde
Degez, Manon
Artifoni, Mathieu
Goronflot, Thomas
Misbert, Emilie
Dochez, Vincent
Winer, Norbert
author_sort Guyon, Mathilde
collection PubMed
description Adrenal necrosis is a rare but serious cause of abdominal pain of thrombotic origin during pregnancy. There is often a delay in diagnosis and treatment. The objective was to specify the clinical and paraclinical signs suggestive of adrenal necrosis, making it possible to improve the delay in diagnostic. The secondary objective was to establish a multidisciplinary protocol regarding management. This is a case report of pregnant women with a radiological diagnosis of adrenal gland necrosis. In parallel, we carried out a systematic review in the same period. We studied these patients’ clinical, biological and radiological data. We included eight patients with a computed tomography scan diagnosis of adrenal necrosis and fifteen articles in the literature describing twenty-four cases. All the patients presented with the same symptoms. The treatment was based on curative anticoagulation. The diagnosis of adrenal gland necrosis is worth suggesting in view of the array of sudden morphine-resistant abdominal pain associated with a biological inflammatory syndrome. The diagnosis is based on the computed tomography scan. Three to six months of curative anticoagulation is recommended as well as a thrombophilia and endocrinological assessment to rule out adrenal insufficiency.
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spelling pubmed-105316842023-09-28 Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review Guyon, Mathilde Degez, Manon Artifoni, Mathieu Goronflot, Thomas Misbert, Emilie Dochez, Vincent Winer, Norbert J Clin Med Systematic Review Adrenal necrosis is a rare but serious cause of abdominal pain of thrombotic origin during pregnancy. There is often a delay in diagnosis and treatment. The objective was to specify the clinical and paraclinical signs suggestive of adrenal necrosis, making it possible to improve the delay in diagnostic. The secondary objective was to establish a multidisciplinary protocol regarding management. This is a case report of pregnant women with a radiological diagnosis of adrenal gland necrosis. In parallel, we carried out a systematic review in the same period. We studied these patients’ clinical, biological and radiological data. We included eight patients with a computed tomography scan diagnosis of adrenal necrosis and fifteen articles in the literature describing twenty-four cases. All the patients presented with the same symptoms. The treatment was based on curative anticoagulation. The diagnosis of adrenal gland necrosis is worth suggesting in view of the array of sudden morphine-resistant abdominal pain associated with a biological inflammatory syndrome. The diagnosis is based on the computed tomography scan. Three to six months of curative anticoagulation is recommended as well as a thrombophilia and endocrinological assessment to rule out adrenal insufficiency. MDPI 2023-09-18 /pmc/articles/PMC10531684/ /pubmed/37762978 http://dx.doi.org/10.3390/jcm12186036 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Guyon, Mathilde
Degez, Manon
Artifoni, Mathieu
Goronflot, Thomas
Misbert, Emilie
Dochez, Vincent
Winer, Norbert
Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title_full Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title_fullStr Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title_full_unstemmed Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title_short Adrenal Gland Necrosis in Pregnancy: How to Manage? Case Series at Nantes University Hospital and Literature Review
title_sort adrenal gland necrosis in pregnancy: how to manage? case series at nantes university hospital and literature review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531684/
https://www.ncbi.nlm.nih.gov/pubmed/37762978
http://dx.doi.org/10.3390/jcm12186036
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