Contrasting Mechanisms and Management of Adrenal Hemorrhage: A Comparative Two-Case Series

Adrenal hemorrhage (AH) is an uncommon condition with variable etiology, including trauma, coagulopathies, infections, and endocrine disorders. Clinical presentation is often nonspecific, ranging from flank or abdominal pain to hemodynamic instability. Prompt imaging with computed tomography and magnetic resonance imaging is essential for diagnosis and characterization. We report two cases of unilateral adrenal hemorrhage: a 75- year- old male with traumatic adrenal hemorrhage associated with multiple fractures and right renal infarction, and a 58- year- old male with spontaneous adrenal hemorrhage accompanied by adrenal vein thrombosis. Both patients were hemodynamically stable and managed conservatively, with favorable clinical and radiologic outcomes. This comparative analysis highlights differences in etiology, presentation, imaging features, and clinical course between traumatic and spontaneous adrenal hemorrhage, emphasizing the importance of early recognition, individualized management, and follow- up.