Introduction: Adrenal haemorrhage (AH) is a rare, life-threatening condition that requires prompt diagnosis and management. Case Report: A 61-year-old male presented with sudden-onset central abdominal pain, distended abdomen, and nausea. There was no history of trauma or any other predisposing factor for AH. The blood pressure was raised, while other vitals were normal. The patient was managed with intravenous Diclofenac, Tablet Amlodipine, and Ryle's tube insertion. Initial abdominal ultrasound revealed bilateral adrenal enlargement. However, non-contrast computed tomography of the abdomen revealed changes suggestive of bilateral AH. These findings were confirmed by magnetic resonance imaging of the abdomen. Though the serum cortisol and adrenocorticotropic hormone levels were normal, and the patients were not symptomatic of adrenal insufficiency, intravenous Methylprednisolone was initiated to prevent deterioration of adrenal function. All the known causes of AH were excluded, and a diagnosis of idiopathic bilateral AH was reached. On Day 7, an abdominal ultrasound revealed a non-progressive size of the bilateral adrenal lesions and the patient was discharged with well-controlled blood pressure. Conclusion: Idiopathic AH, in patients without any predisposing factors, should be included in the differential diagnosis of a patient with vague abdominal pain.
Key words: Adrenal gland, Adrenal hemorrhage, Case report, Idiopathic, Steroid therapy
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