Hemorrhagic shock secondary to pre-existing adrenal myelolipoma: a case report and review of the literature.

Background: Adrenal myelolipomas are benign tumors composed of mature adipose tissue and hematopoietic elements, such as myeloid and erythroid cells. They are often asymptomatic and do not require treatment unless complications arise.

Methods: A case description and brief review of the literature is performed.

Results: This case report outlines the hospital course and management of a 77-year-old woman who was admitted to the emergency department with hemorrhagic shock after a traumatic fall. A full body computed tomography (CT) scan revealed a voluminous mass in the right adrenal gland with an active hemorrhage in the right hypochondrium. After reviewing her medical records, it became clear that the hemorrhage arose from a pre-existing adrenal myelolipoma, discovered nine years earlier. Additionally, she sustained multiple fractures including right-sided rib fractures, a compression fracture of L1, and a complex fracture of the right scapula, accompanied by a significant hematoma. The clinical approach included initial stabilization, embolization procedures to control the hemorrhage, and comprehensive follow-up care.

Conclusion: This case illustrates that timely recognition and management of traumatic hemorrhage from pre-existing masses, such as an adrenal myelolipoma, are crucial for improving patient outcomes and minimizing complications such as hypovolemic shock.