Acute bilateral adrenal hemorrhage secondary to rough truck ride

Acute bilateral adrenal hemorrhage secondary to indirect trauma is rare. This condition may mimic an acute surgical abdomen. We present such a patient in whom the anatomic diagnosis was confirmed by serial computed tomographic (CT) scans, and adrenal insufficiency by biochemical tests. The response to steroid replacement therapy was remarkable. Although the patient had normal coagulation parameters at the time of presentation, subtle changes resulting from earlier anticoagulation may have been a contributing factor.