Huge retroperitoneal hemorrhage due to adrenal artery injury without visceral organ injury

We report a case of huge retroperitoneal hemorrhage with active contrast extravasation due to right adrenal artery injury without visceral organ injury. A 67-year-old woman was involved in an out car traffic accident. She sustained multiple traumatic injuries and right adrenal artery injury without visceral organ injury. Abdominal computed tomography scan showed huge retroperitoneal hemorrhage with active contrast extravasation. But, there is no evidence of renal injury. Renal angiography confirmed contrast media extravasation from right adrenal artery. Selective embolization of adrenal artery was attempted but, adrenal arterial lumen was spontaneously obstructed due to arterial spasm. To our knowledge, isolated adrenal artery injury occurring huge retroperitoneal hemorrhage have not been described previously. Awareness of this possible cause of retroperitoneal hemorrhage may assist in immediate diagnosis and appropriate treatment.