抗凝固剤が誘因と考えられた副腎出血

A case of adrenal hemorrhage due to administration of anticoagulant

患者は72歳，男性。腹痛を主訴に受診となる。70歳時に心房細動，心房粗動，洞不全症候群，脳梗塞のためペースメーカーを留置され，ワーファリンとアスピリンにて投薬加療されていた。腹部CT検査にて左副腎領域に10cm大の腫瘤を認めた。身体所見，内分泌学的検査に異常はみられなかった。発症から2か月後，経腰的副腎摘除術を施行し，病理学的に副腎出血と診断した。手術から7年間，出血の再発は認めていない。

A 72-year-old man was admitted to our hospital with chief complaint of abdominal pain. Artifical pacemaker, warfarin and aspirin had been administered for atrial fibrillation, atrial flutter, sick sinus syndrome and cerebral infarction for the past 2 years. Abdominal computed tomography showed left adrenal mass 10 cm in diameter. Physical and laboratory examinations of adrenal function revealed normal results. A adrenal carcinoma, was suspected and left adrenalectomy was performed. The pathological diagnosis was adrenal hemorrhage. He has been followed up for 7 years without any evidence of the recurrence.