Non-surgically treated case of nonfunctioning ruptured adrenal adenoma in a patient on hemodialysis

Objectives: Herein, we report a case of rupture of nonfunctional adrenal adenoma treated by nonsurgical supportive management due to high risk for operation. Method and case: A patient with end stage renal disease (ESRD) who was on hemodialysis visited our emergency room and complained of a sudden abdominal pain after a fall. A retroperitoneal hemorrhage with hematoma formation around the adrenal adenoma, which was caused by rupture of the adrenal adenoma, was detected by abdominal computed tomography (CT). Results: Supportive management was performed, with serial CT follow-up instead of surgical adrenalectomy treatment because of high operative risk, due to hemodialysis. After 1 week, the patient’s vital signs stabilized and the patient did not further complain about abdominal symptoms. However, supportive embolization was performed and the size of hematoma was more decreased. Conclusion: We report a case of a patient on hemodialysis who experienced a rupture of a nonfunctioning adrenal adenoma, which was caused by low-energy trauma. The patient’s conditions improved with nonsurgical supportive management including embolization.