Overview
Adrenal abscess is a rare but serious infection involving the adrenal gland, often presenting as a localized mass with potential for systemic complications due to its proximity to major vascular structures 2.Diagnosis
Imaging: Computed tomography (CT) is crucial for diagnosis, revealing an adrenal mass with possible extension into adjacent structures like the renal hilum and inferior vena cava 2.
Aspiration and Drainage: Needle aspiration can confirm diagnosis via identification of purulent material 1.
Pathology: Histopathologic examination confirms the presence of abscess with purulent debris 2.Management
Percutaneous Drainage: First-line treatment for nonsurgical management, particularly in neonates 1.
Antibiotics: Broad-spectrum antibiotics are typically initiated empirically, tailored based on culture and sensitivity results (specific drug classes/doses not detailed in abstracts).
Supportive Care: Includes management of systemic symptoms and monitoring for complications such as sepsis 12.Special Populations
Neonates: Nonsurgical approaches like percutaneous drainage are feasible and effective 1.Key Recommendations
Utilize CT imaging for definitive diagnosis and assessment of extension (Evidence: Moderate 2).
Consider percutaneous drainage as a primary treatment modality, especially in neonates (Evidence: Weak 1).
Initiate broad-spectrum antibiotics and tailor based on culture results (Evidence: Expert opinion).References
1 Mondor C, Gauthier M, Garel L, Filiatrault D, Grignon A. Nonsurgical management of neonatal adrenal abscess. Journal of pediatric surgery 1988. link80026-5)
2 O'Brien WM, Choyke PL, Copeland J, Klappenbach RS, Lynch JH. Computed tomography of adrenal abscess. Journal of computer assisted tomography 1987. link