Radiological treatment of a spontaneously ruptured inferior adrenal artery aneurysm.

BACKGROUND

A 70-year-old man with a history of hypertension presented with severe epigastric discomfort that radiated to his back. CT revealed cystic kidney disease and a large retroperitoneal hemorrhage, and CT angiography identified an active bleeding point in the region of the left adrenal gland. Selective left renal angiography identified a small inferior adrenal artery aneurysm with active hemorrhage. The patient underwent successful transcatheter embolization with microcoils and polyvinyl alcohol microparticles to control the bleeding.

INVESTIGATIONS: Blood tests, urinalysis, electrocardiography, triphasic CT with CT angiography.

DIAGNOSIS: Ruptured left inferior adrenal artery aneurysm.

MANAGEMENT: Access to the inferior adrenal artery was achieved with a microcatheter, followed by transcatheter embolization using a combination of polyvinyl alcohol microparticles distally and microcoils proximally to the aneurysm.