Referred Pain from the Adrenal Area During Selective Renal Angiography

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WHEREAS numerous diseases affect the adrenal gland, pain as a symptom is rare. A review of the literature indicates that pain in the abdomen or in the costovertebral region is sometimes encountered. However, a consistent reference of pain from the adrenal area is not generally recognized. During the procedure of selective renal angiography in a series of 65 patients, 5 patients have experienced pain in the chest. Analysis of this discomfort in relationship to pain referred from the adrenal area is the subject of this report.

Injection of radiographic contrast material into peripheral arteries is usually associated with subjective discomfort in the region supplied by the artery. Representative examples are pain in the shoulder from injection of the costocervical trunk of the subclavian artery, discomfort in the thyroid and laryngeal region from injection of the thyrocervical trunk of the subclavian artery, pain in the face from injection of the external carotid artery, and pain in the back from injection of a lumbar artery. This pain, generally ascribed to the irritating effect of the contrast agent, is usually sharp, burning in character, and brief, lasting from 5 to 10 seconds after the injection. This pain is followed by a feeling of warmth in the part injected. The intensity of the pain is usually directly proportional to the concentration and type of the opacifying medium.

Other arteries that are opacified rarely produce symptoms. Injection of contrast material into the splenic artery, the hepatic artery, and the mesenteric arteries usually produce no symptoms . . .



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