Adrenal Hemorrhage, a Simple Guide to the Condition, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Adrenal Hemorrhage, Diagnosis and Treatment and Related Diseases

An adrenal hemorrhage is bleeding within the adrenal gland, the triangular-shaped gland on top of each kidney.

Adrenal hemorrhage also termed adrenal apoplexy is a relatively rare disorder with an inconsistent and nonspecific manifestation that may cause acute adrenal crisis, shock and death unless it is diagnosed promptly and treated properly.

Patients with adrenal hemorrhage may die due to underlying disease or diseases linked with adrenal hemorrhage, in spite of treatment with stress-dose glucocorticoids.

Overall, adrenal hemorrhage is linked with a 15% mortality rate, which differs based on the severity of the underlying illness predisposing to adrenal hemorrhage.

Patients with Waterhouse-Friderichsen syndrome (adrenal hemorrhage happening in sepsis, most often meningococcal) have a 55-60% mortality rate.

While adrenal hemorrhage may happen in people of any age, most patients with non-traumatic, excessive, bilateral adrenal hemorrhage are aged 40-80 years at the moment of the acute event.

Patients with traumatic adrenal hemorrhage normally are in the 2nd to 3rd decade of life.

Most patients with Waterhouse-Friderichsen syndrome are in the children age group, even though adults have seldom been affected.

Adrenal hemorrhage in neonates is a well-described disorder and has even been diagnosed in uterus.

Chronic adrenal insufficiency happens in most patients who survive extensive, bilateral adrenal hemorrhage, requiring long-term glucocorticoid replacement.

In contrast, the necessity for mineralocorticoid replacement is inconsistent.

Androgen replacement treatment may also be helpful in women with chronic adrenal insufficiency.

It can happen in a person of any age, but is more often seen in the 40 to 80 year age group.

The disorder at times is not diagnosed and is only detected upon conducting an autopsy.

The bleeding may be present only in one adrenal gland (unilateral) or on both sides (bilateral).

When bleeding happens on one side, the other gland is able to balance with production and secretion of the necessary adrenal hormones.

It is evaluated that some 15% of people who die of shock show evidence of adrenal hemorrhage on both sides (bilateral).

The causes of both unilateral (one-sided) and bilateral (both sides) adrenal hemorrhage may have frequent features.

Unilateral Adrenal Hemorrhage
1. Blunt trauma
2. Abdominal surgery of organs or structures near the adrenal gland
3. Cancer of the adrenal gland
4. Long term use of NSAIDs (non-steroidal anti-inflammatory drugs)
5. Pregnancy without complications
6. Unknown causes (idiopathic)

Bilateral Adrenal Hemorrhage

1. Infections
2. Heart diseases like congestive cardiac failure or a myocardial infarction (heart attack).
3. Cirrhosis (liver)
4. Pancreatitis
5. Inflammatory bowel disease
6. Severe abdominal injury
7. Pregnancy complications
8. Surgery like coronary artery bypass, hip replacement and intracranial procedures.
9. Bleeding disorders like thrombocytopenia and use of blood thinning drugs.
10. Vascular disorders including deep venous thrombosis
11. Cancer spread from another site
12. Waterhouse-Friderichsen syndrome

TABLE OF CONTENT
Introduction
Chapter 1 Adrenal Hemorrhage
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Adrenal Crisis
Chapter 8 Life and Death of Adrenal Gland
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: May 30, 2021
• ISBN: 9781005961015

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Adrenal Hemorrhage,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2021 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Adrenal Hemorrhage, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Adrenal Hemorrhage)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Adrenal hemorrhage

What is Adrenal Hemorrhage?

An adrenal hemorrhage is bleeding within the adrenal gland, the triangular-shaped gland on top of each kidney.

Adrenal hemorrhage is an infrequent disorder but can be life threatening unless medical treatment is initiated as soon as possible.

Adrenal hemorrhage also termed adrenal apoplexy is a relatively rare disorder with an inconsistent and nonspecific manifestation that may cause acute adrenal crisis, shock and death unless it is diagnosed promptly and treated properly.

Patients with adrenal hemorrhage may die due to underlying disease or diseases linked with adrenal hemorrhage, in spite of treatment with stress-dose glucocorticoids.

Overall, adrenal hemorrhage is linked with a 15% mortality rate, which differs based on the severity of the underlying illness predisposing to adrenal hemorrhage.

Patients with Waterhouse-Friderichsen syndrome (adrenal hemorrhage happening in sepsis, most often meningococcal) have a 55-60% mortality rate.

While adrenal hemorrhage may happen in people of any age, most patients with non-traumatic, excessive, bilateral adrenal hemorrhage are aged 40-80 years at the moment of the acute event.

Patients with traumatic adrenal hemorrhage normally are in the 2nd to 3rd decade of life.

Most patients with Waterhouse-Friderichsen syndrome are in the children age group, even though adults have seldom been affected.

Adrenal hemorrhage in neonates is a well-described disorder and has even been diagnosed in uterus.

Chronic adrenal insufficiency happens in most patients who survive extensive, bilateral adrenal hemorrhage, requiring long-term glucocorticoid replacement.

In contrast, the necessity for mineralocorticoid replacement is inconsistent.

Androgen replacement treatment may also be helpful in women with chronic adrenal insufficiency.

There are reports of patients who had total recovery of adrenal function after an event of extensive, bilateral adrenal hemorrhage and acute adrenal insufficiency.

It can happen in a person of any age, but is more often seen in the 40 to 80 year age group.

The disorder at times is not diagnosed and is only detected upon conducting an autopsy.

The bleeding may be present only in one adrenal gland (unilateral) or on both sides (bilateral).

When bleeding happens on one side, the other gland is able to balance with production and secretion of the necessary adrenal hormones.

It is evaluated that some 15% of people who die of shock show evidence of adrenal hemorrhage on both sides (bilateral).

What are the causes of Adrenal Hemorrhage?

Causes

The causes of both unilateral (one-sided) and bilateral (both sides) adrenal hemorrhage may have frequent features.

Unilateral Adrenal Hemorrhage

1. Blunt trauma

2. Abdominal surgery of organs or structures near the adrenal gland

3. Cancer of the adrenal gland

4. Long term use of NSAIDs (non-steroidal anti-inflammatory drugs)

5. Pregnancy without complications

6. Unknown causes (idiopathic)

Unilateral adrenal hemorrhage most often is produced by blunt abdominal trauma (traumatic adrenal rupture.

Unilateral adrenal hemorrhage due to blunt trauma more often involves the right adrenal.

Liver hematomas and rib fractures often happen in these patients.

Unilateral adrenal hemorrhage happens in 2% of patients with penetrating trauma.