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首页> 外文期刊>BMC Surgery >Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature
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Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

机译：腹腔出血伴失血性休克：一例肾上腺骨髓脂肪瘤及文献复习

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Background Adrenal myelolipoma is an uncommon, benign, and hormonally non-functioning tumor that is composed of mature adipose tissue and normal hematopoietic tissue. Most cases to date are asymptomatic or have epigastric pain. Acute hemorrhage is the most dramatic manifestation of adrenal myelolipoma; though, it is a rare entity. Hemorrhagic shock due to adrenal myelolipoma, to our knowledge, was much less mentioned so far. Persistent bleeding and uncontrollable hypotension are considered to be absolute indications for immediate surgical operation. Case presentation Herein we presented a 32-year-old male patient with initial symptoms of nausea, vomiting, and epigastric pain progressing to altered consciousness and hypotension during ER course. Hemorrhagic shock due to a giant adrenal myelolipoma, R’t was diagnosed. Emergent exploratory laparotomy was executed, and en bloc excision of tumor was done. Conclusion Adrenal myelolipoma might be diagnosed as a adjunction to other main causes of illness; furthermore, adrenal myelolipoma could be asymptomatic in lifetime. In our case, however, manifesting as hemorrhage shock was challenging to diagnose step by step; instead, maintaining vital organs perfusion and identifying bleeding sources were to be done. Management of myelolipoma should be done on a case-to-case basis.
机译：背景肾上腺髓样脂肪瘤是一种罕见的，良性的，无激素功能的肿瘤，由成熟的脂肪组织和正常的造血组织组成。迄今为止，大多数病例无症状或有上腹痛。急性出血是肾上腺骨髓脂肪瘤最明显的表现。但是，这是一个罕见的实体。据我们所知，迄今为止，由于肾上腺骨髓瘤引起的失血性休克很少提及。持续性出血和无法控制的低血压被认为是立即进行手术的绝对指征。病例介绍本文介绍了一名32岁的男性患者，其初始症状为恶心，呕吐和上腹部疼痛，在ER过程中逐渐发展为意识和低血压改变。由于未诊断出巨大的肾上腺骨髓脂肪瘤而导致失血性休克。紧急进行探索性剖腹手术，并整块切除肿瘤。结论肾上腺髓样脂肪瘤可能被诊断为其他主要病因的辅助。此外，肾上腺髓样脂肪瘤可能终生无症状。但是，在我们的案例中，表现为大出血性休克对于逐步诊断具有挑战性。取而代之的是，维持重要器官的灌注并确定出血源。应根据具体情况进行骨髓脂肪瘤的治疗。

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