Spontaneous Idiopathic Bilateral Adrenal Haemorrhage in Adults

Haemorrhage into the adrenal gland may be unilateral or bilateral. It occurs most frequently in the newborn, but has been well documented in older children and adults [1]. Bilateral adrenal haemorrhage is usually associated with anticoagulant therapy or stress caused by surgery, sepsis or hypotension [1–4]. Less common causes include trauma or hypoxia during obstetric delivery. Bilateral adrenal haemorrhage is rarely diagnosed clinically owing to its relatively non-specific presentation. The clinical importance of bilateral adrenal haemorrhage is that it may lead to acute adrenal insufficiency and possible death [5]. We report for the first time, two cases of idiopathic spontaneous bilateral adrenal haemorrhage in adults, identified at time of computed tomography (CT) imaging performed for abdominal pain.