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Anatomy of the Normal Adrenal Vein

David T. Purtilo, MD, MS
JAMA. 1971;215(8):1329. doi:10.1001/jama.1971.03180210073032.
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To the Editor.—  The recent article by Eagan and Page on "Adrenal Insufficiency Following Bilateral Adrenal Venography" (215:115-116, 1971) contained a statement that the adrenal insufficiency and hemorrhage was "a result of fragile veins associated with the atrophic gland usually found in patients with primary aldosteronism." Brookstein et al1 reported intramedullary hemorrhage in five of nine adrenals after venography in patients with aldosteronism. I have heard similar tales of woe in clinical presentations in both Boston and Minneapolis. At no time have I encountered a discussion of the histological factors of the normal adrenal vein which may predispose this vessel to catheter trauma and hemorrhage.The intraparenchymal portion of the central adrenal vein has a unique thin-thick wall architecture2-4 (Figure).Knowledge of the normal histological structure of the adrenal vein wall has become increasingly relevant at this time when adrenal venography is done frequently. Some of the


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