Bilateral Adrenal Hemorrhage Secondary to Heparin-induced Thrombocytopenia

A 63-year-old woman presented with constipation and abdominal pain. Computed tomography (CT) scan of abdomen without contrast showed evidence of sigmoid volvulus. She underwent subtotal colectomy and was subsequently discharged without any complications. Two days later, she was readmitted due to worsening abdominal pain. Abdominal X-ray showed paralytic ileus and she was managed with supportive treatment. During hospital stay, she developed a fever of 38.8°C and became hypotensive. She was empirically treated with broad spectrum antibiotics.