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Master Thesis

Étude de cas : nécrose unilatérale des glandes surrénales à 25 semaines d'aménorrhées

Abstract : Objectives: From the example of an unilateral adrenal necrosis during pregnancy and a review, we presented its characteristics and its challenges in order to improve the diagnosis process and the etiological approach. Methods: We read and analysed the medical file of a patient affected by an adrenal necrosis during her pregnancy. Then, through scientific databanks, academic societies and books, we realized a review. Results: A healthy 24-years-old woman, G1P0, presented herself at obstetrical emergency at 25 weeks of gestation with severe lumbar pain and vomiting. Tests only revealed hyperleukocytosis and hyperkalemia. After 48h, adrenal necrosis has been diagnosed at contrast-enhanced computed tomography scan. Unilateral adrenal necrosis usually affects low-risk-patients during normal pregnancies. Its biological and clinical presentation is equivocal. There is no adrenal insufficiency in unilateral cases. The diagnosis¸ often delayed, is made by magnetic resonance imageor contrast-enhanced computed tomography scan. Unilateral adrenal necrosis is caused by adrenal thrombosis; in one third of the time, a thrombophilia is found. Conclusion: Unilateral adrenal necrosis during pregnancy is little known by medical community. Doctors have to think about it when a patient has unilateral lumbar pain, with digestive disorders and hyperleukocytosis without fever and without obvious etiology. Medical imaging assesses the diagnosis. Doctors should not be afraid to use it because if not, it could lead to delay or mistakes.
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Submitted on : Tuesday, May 11, 2021 - 2:18:39 PM
Last modification on : Wednesday, October 20, 2021 - 12:24:16 AM
Long-term archiving on: : Thursday, August 12, 2021 - 6:59:07 PM

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  • HAL Id : dumas-03224161, version 1

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Bénédicte Foct. Étude de cas : nécrose unilatérale des glandes surrénales à 25 semaines d'aménorrhées. Gynécologie et obstétrique. 2020. ⟨dumas-03224161⟩

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