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Case Reports in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 859068, 2 pages
http://dx.doi.org/10.1155/2012/859068
Case Report

Spontaneous Rupture of an Adrenal Artery in Pregnancy: A Case Report

Department of Obstetrics and Gynecology, Cantonal Hospital of St. Gallen, Rorschacher Straß 95, 9007 St. Gallen, Switzerland

Received 31 October 2012; Accepted 11 December 2012

Academic Editors: M. F. Diejomaoh and C. Ficicioglu

Copyright © 2012 D. Bolla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A spontaneous rupture of an adrenal artery is a rare cause of abdominal pain in pregnancy. We present a case of a pregnant woman who needed to be operated on because of a rupture of the right adrenal artery associated with a fetal bradycardia. An immediate caesarean section was performed. The intra-abdominal palpation identified an extensive retroperitoneal mass near the right kidney and a postoperative computer tomography confirmed an active bleeding near the kidney. For this reason our interventional radiology team, using a right femoral artery approach, performed a flush aortogram and identified the source of bleeding in the right adrenal artery. After two attempts, a coiling of the artery stopped the haemorrhage. The pathogenesis of arterial haemorrhage is still poorly understood although a possible cause could be the excess of hormones during pregnancy, which can lead to a significant arterial wall degeneration. In case of a retroperitoneal bleeding and if the patient is still haemodynamically stable, a transcatheter embolization using microcoils must be considered. This technique is nowadays safe and effective and can be performed within a short time with a lower risk of complications.