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2011-02-23-11 Answer to the case of the week #296 © Manohar

Answer to the case of the week #296

June 23, 2011 - July 7, 2011.

Sivasamy Manohar, MD.

Madurai Scans, India.

Case report

This is a case of a 41-year-old G1P0. This patient was treated for infertility and conceived after the long period of time. The ultrasound performed at 35 weeks of gestation diagnosed an anechoic mass in the area of the left adrenal gland. The color Doppler of the renal veins showed a thrombosis of the renal vein on the same side as the affected adrenal gland.

Our diagnosis based on the ultrasound exam was a spontaneous adrenal hemorrhage with renal vein thrombosis.

Unfortunately, the neonate died 1 week after delivery. There were no associated anomalies or signs of uteroplacental insufficiency.

Images 1,2: 35 weeks, Image 1 shows left kidney with the left adrenal gland. Adrenal gland is enlarged with encapsulated anechoic mass. Image 2 shows a sagittal view of the left kidney with the affected adrenal gland.


Images 3,4: Image 3 shows a transverse view of the left adrenal gland with a hemorrhage. Image 4 shows the sagittal view of the left kidney and adrenal gland.


Image 5,6: Image 5 shows a cystic anechoic mass in the left adrenal gland representing a hemorrhage. Image 6 shows transverse view of the left kidney which seems echoic and enlarged.


Images 7,8: Image 7 shows a normal flow in the right renal vein. Image 7 shows a left renal vein which was thrombosed.


Images 9,10: Image show a high-resistance flow in the left renal artery.


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