Cushing’s
Syndrome
Suprarenal cortical hyperplasia is the most common cause of Cushing’s
syndrome, the clinical manifestations of which include moon-shaped face,
truncal obesity, abnormal hairiness (hirsutism), and hypertension; if the
syndrome occurs later in life, it may result from an adenoma or carcinoma of
the cortex.
Addison’s
Disease
Adrenocortical insufficiency (Addison’s disease), which is characterized
clinically by increased pigmentation, muscular weakness, weight loss, and
hypotension, may be caused by tuberculous destruction or bilateral atrophy of
both cortices.
Pheochromocytoma
Pheochromocytoma, a tumor of the medulla, produces a
paroxysmal or sustained hypertension. The symptoms and signs result from the
production of a large amount of catecholamines, which are then poured into the
bloodstream. Because of their position on the posterior abdominal wall, few
tumors of the suprarenal glands can be palpated. CT scans can be used to
visualize the glandular enlargement; however, when interpreting CT scans,
remember the close relationship of the suprarenal glands to the crura of the diaphragm.
Surgical
Significance of the Renal Fascia
The suprarenal glands, together with the kidneys, are
enclosed within the renal fascia; the suprarenal glands, however, lie in a separate
compartment, which allows the two organs to be separated easily at operation
Aortic
Aneurysms
Localized or diffuse dilatations of the abdominal part of
the aorta (aneurysms) usually occur below the origin of the renal arteries. Most
result from atherosclerosis, which causes weakening of the arterial wall, and
occur most commonly in elderly men. Large aneurysms should be treated by open surgical
repair. Endovascular repair can also be used by the introduction of a stent
graft through one of the iliac arteries with access through the femoral
arteries in the groin.
Embolic
Blockage of the Abdominal Aorta
The bifurcation of the abdominal aorta where the lumen
suddenly narrows may be a lodging site for an embolus discharged from the heart.
Severe ischemia of the lower limbs results
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