@article{oai:ir.kagoshima-u.ac.jp:00000603,
 author = {IKENOUE, Aya and BABA, Yasutaka and HAYASHI, Sadao and TANABE, Hiroaki and NAKAJO, Masayuki},
 issue = {3},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {},
 note = {A 61-year-old woman was admitted to our Department for examination of uncontrollable hypertension. An aldosteroneproducing
adenoma (aldosteronomas) was suspected based on her hypertension, low plasma renin activity and a right
adrenal mass on CT, although plasma and urinary aldosterone levels were within normal ranges. Because of the ambiguous
hormonal results, we performed adrenal vein sampling including bilateral adrenal veins and the inferior vena cava. The
results of aldosterone and cortisol levels of the blood samples reported later confirmed an aldosteronomas in the right
adrenal gland. Immediately after the second right adrenal venography after successful sampling followed by the first
uneventful right venography, the patient complained of back pain and CT revealed the swollen right adrenal gland with high
density, suggesting a complication of intra-adrenal hemorrhagic venous infarction. Thereafter, her hypertension improved,
plasma aldosterone levels decreased to a lower normal limit, and plasma renin activity returned to a normal range. CT
obtained 3 months later and adrenocortical scintigraphy performed 6 months later revealed that most of the aldosteronoma
was necrotic. During the 9-months follow-up period, hormonal ablation of the aldosteronoma was maintained. Although
hormonal ablation of the aldosteronoma was fortuitously obtained in our case, adrenal venography should be performed
with meticulous care and after confirmation of smooth blood flow into the syringe connected with the catheter by pulling
the plunger.　Manual injection of the contrast medium into the adrenal vein should be made as gentle and slow as possible
to avoid complications, especially in case of prolonged wedge of the catheter tip in the adrenal vein.},
 pages = {65--71},
 title = {Fortuitous Hormonal Ablation of Adrenal Aldosteronoma due toa Complication, Adrenal Venous Infarction by Adrenal Venographyduring Adrenal Vein Sampling: Case Report},
 volume = {60},
 year = {2009}
}