Giant Bilateral Adrenal Myelolipoma

A 36-year-old Hispanic female diagnosed with non-classical congenital adrenal hyperplasia and salt wasting disorder on chronic exogenous steroids presented to our emergency department with excruciating bilateral flank pain, 10/10 in intensity, associated with nausea, vomiting, and generalised weakness. On examination, the patient was in hypovolemic shock with BP of 65/45 mmHg, MAP 52 mmhg, and HR 110 b/min. She was resuscitated with intravenous fluids and intravenous corticosteroids. Physical examination was otherwise unremarkable.