Calcified adrenal glands and Spigelian hernia

Discussion:

Previous tuberculosis infection of the adrenal glands left the patient with Addison disease and requiring lifelong steroid replacement therapy. The other main differential for such adrenal calcification is adrenal hemorrhage.

The pain and swelling were due to the Spigelian hernia. When surgery is considered in patients with Addison's disease, close attention should be paid to post-operative steroid replacement as the stress of surgery necessitates a change in steroid dose to prevent an Addisonian crisis.

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