RESUMO
A 72-year-old man was admitted for gastric ulcer related to oral non-steroidal antiinflammatory drugs (NSAID). The plain film of the abdomen revealed a calcified mass in the right hypochondrium measuring 10 cm in diameter. Ultrasonography, computed tomography and magnetic resonance imaging led to the diagnosis of adrenal hematoma, thus avoiding unnecessary surgery. The pathogenic mechanisms of spontaneous adrenal hematoma is related to hypervascularization of the adrenal gland. The role of stress is demonstrated.
Assuntos
Doenças das Glândulas Suprarrenais/diagnóstico , Hematoma/diagnóstico , Doenças das Glândulas Suprarrenais/complicações , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Calcinose/diagnóstico , Calcinose/etiologia , Hematoma/complicações , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Masculino , Úlcera Gástrica/induzido quimicamente , Úlcera Gástrica/complicaçõesRESUMO
BACKGROUND: Vitamin B1 deficiency (beriberi) is very uncommon in France. It leads to high output cardiac failure totally different from the situation observed in alcoholic patients. We report a typical case of cardiac beriberi. CASE REPORT: The patient was referred for dyspnea with high output cardiac failure. Echocardiography evidenced severe pulmonary hypertension and high cardiac output. The more common causes of heart failure were ruled out. The dietary habits of the patient (suggested beriberi which was confirmed by the low serum thiamin and therapeutic test with vitamin B1. DISCUSSION: High output cardiac failure should suggest possible Shoshin beriberi, particularly in subjects with imported dietary habits living in a precarious socioeconomic situation.