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Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys

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AP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, France
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Faculté de Médecine Paris-Sud, Université Paris-Saclay, 94270 Le Kremlin Bicêtre, France
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AP-HP, Hôpital Kremlin Bicêtre, Service de Radiologie, 94270 Le Kremlin Bicêtre, France
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AP-HP, Hôpital Antoine Béclère, Service de Chirurgie Digestive, 92140 Clamart, France
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AP-HP, Hôpital Antoine Béclère, Service de Gynécologie-Obstétrique, 92140 Clamart, France
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BIOMAPS, UMR 9011 Université Paris-Saclay, 4 pl. du Général Leclerc, CEDEX, 91401 Orsay, France
*
Author to whom correspondence should be addressed.
Academic Editor: Michael Garwood
Tomography 2021, 7(4), 533-544; https://doi.org/10.3390/tomography7040046
Received: 5 August 2021 / Revised: 20 September 2021 / Accepted: 2 October 2021 / Published: 6 October 2021
Background: non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ultrasounds (USs), computed tomography (CT), and magnetic resonance imaging (MRI) of recent NHAI cases. Methods: we compiled all consecutive NHAI cases from two university hospitals over a two-year period and checked the relevant clinical, laboratory, and imaging findings. Relevant articles on NHAI published from January 2010 to March 2021 were analyzed. Results: six cases were found in our database. CT-scans typically showed enlarged, hypodense, and non-enhanced adrenal glands. Unenhanced MRIs allowed for diagnoses and showed enlarged adrenal glands in the signal hyperintensity on T2 and diffusion-weighted imaging, without any signal hyperintensity on T1. In two of our six cases, USs showed swollen adrenal glands with fluid collection. Conclusion: NHAI and its differential diagnosis—in cases of acute pain during pregnancy—highlight the crucial roles of integrated radiological examination and cooperation between obstetricians and radiologists, both of whom should consider the location of the pain, the accessibility and tolerance of MRI, and the radiation exposure of CT. Despite its supposed poor sensitivity, an US performed because the patient reports pain should also be used to examine the adrenal gland regions. Non-enhanced MRI is clearly of value and access to it in emergencies is important to avoid radiation exposure View Full-Text
Keywords: adrenal infarction; abdominal pain in pregnancy; non-hemorrhagic adrenal infarction; adrenal thrombosis; adrenal ischemia; MRI; management adrenal infarction; abdominal pain in pregnancy; non-hemorrhagic adrenal infarction; adrenal thrombosis; adrenal ischemia; MRI; management
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MDPI and ACS Style

Chagué, P.; Marchi, A.; Fechner, A.; Hindawi, G.; Tranchart, H.; Carrara, J.; Vivanti, A.J.; Rocher, L. Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys. Tomography 2021, 7, 533-544. https://doi.org/10.3390/tomography7040046

AMA Style

Chagué P, Marchi A, Fechner A, Hindawi G, Tranchart H, Carrara J, Vivanti AJ, Rocher L. Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys. Tomography. 2021; 7(4):533-544. https://doi.org/10.3390/tomography7040046

Chicago/Turabian Style

Chagué, Pierre, Antoine Marchi, Alix Fechner, Ghina Hindawi, Hadrien Tranchart, Julie Carrara, Alexandre J. Vivanti, and Laurence Rocher. 2021. "Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys" Tomography 7, no. 4: 533-544. https://doi.org/10.3390/tomography7040046

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