Persistent Adrenal Enhancement may be the Earliest CT Sign of Significant Hypovolaemic Shock
| Autor: | Fu-Luk Chan, H.K.S. Tung, Regina Lai Tong Lee, S.C.W. Cheung |
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| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
Iohexol Liver Abscess Contrast Media Inferior vena cava Fatal Outcome Radiologic sign Adrenal Glands medicine Intravascular volume status Humans Radiology Nuclear Medicine and imaging Obturator hernia Aged Aged 80 and over Pyogenic liver abscess business.industry Septic shock General Medicine Middle Aged medicine.disease Shock Septic medicine.anatomical_structure medicine.vein Shock (circulatory) Abdomen Female Radiology medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | Clinical Radiology. 58:315-318 |
| ISSN: | 0009-9260 |
| Popis: | AIM: To report two cases of intense and persistent adrenal enhancement on computed tomography (CT) examinations of the abdomen. MATERIALS AND METHODS: Two patients presented with septic shock, one due to pyogenic liver abscess and the other strangulated obturator hernia with gangrenous bowel. Both patients were resuscitated with fluid before undergoing unenhanced and enhanced CT. RESULTS: In both patients intravascular volume was not reduced as evident by normal calibre of the aorta and inferior vena cava. One patient had abnormal enhancement pattern in the liver and kidneys, suggesting hypoperfusion. The other patient had normal enhancement pattern of the other abdominal viscera. Both patient subsequently died with multi-organ failure. CONCLUSION: We propose that adrenal enhancement may be a sign of hyperperfusion in early stage of shock due to the crucial role of the adrenal glands in this clinical situation. This may not persist with further circulatory compromise due to vasoconstriction. If confirmed, its recognition has potential value of identifying a therapeutic window before irreversible shock set in. |
| Databáze: | OpenAIRE |
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