Right adrenal gland !
The right adrenal gland is a small gland on top of the right kidney, tucked behind the liver; it makes cortisol, aldosterone and adrenaline.
Official name: Suprarenal gland
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What it is
A pyramid-shaped gland on top of the right kidney, tucked behind the inferior vena cava.
What it does
Makes adrenaline (stress response), cortisol (energy, inflammation, stress) and aldosterone (salt and blood pressure). Its short vein drains straight into the inferior vena cava.
Key facts
- Where
- Retroperitoneal on the superomedial pole of the right kidney, inside renal fascia; pyramidal, directly behind the IVC and against the bare area of the liver
- Blood supply
- Superior (inferior phrenic), middle (aorta) and inferior (renal) suprarenal arteries; one short vein straight into the IVC (easily torn at adrenalectomy)
- Nerve
- Preganglionic sympathetic fibres (T10–L1, via splanchnic nerves) synapse directly on medullary chromaffin cells (some texts: T8–L1)
- Function
- Cortex: aldosterone (glomerulosa), cortisol (fasciculata), androgens (reticularis); medulla: adrenaline and noradrenaline
Relations
- In front
- Inferior vena cava medially, bare area of the liver laterally; sometimes the duodenum below
- Behind
- Right crus of the diaphragm
- Medial
- Right celiac ganglion and the right crus
- Below
- Upper pole of the right kidney, separated by fat and a septum of renal (Gerota) fascia
How to find it
Not palpable. In laparoscopic surgery it is found after the right lobe of the liver is lifted, behind the lateral edge of the inferior vena cava and above the upper pole of the kidney.
On imaging
On CT it appears as a thin line or comma behind the inferior vena cava, between the liver and the right crus. Incidentalomas are assessed as on the left; a mass here can press on the vena cava.
Common problems
- Small nodules found by chance on CT (incidentalomas), mostly harmless.
- Tumours that make too much hormone (high blood pressure, Cushing syndrome).
How it is diagnosed
Blood and urine hormone tests; CT or MRI.
Treatment
- Monitoring, medicines, or laparoscopic removal (adrenalectomy).
Clinical notes
- In right adrenalectomy the short vein is found and tied at the edge of the vena cava before the gland is freed, to avoid bleeding from the cava
- Pheochromocytoma, aldosterone-producing (Conn) and cortisol-producing (Cushing) adenomas occur on either side; this side's vein makes surgery and sampling harder
- Bilateral adrenal hemorrhage, as in meningococcal sepsis (Waterhouse–Friderichsen syndrome), causes acute adrenal failure
Anatomical variants
- Small accessory nodules of adrenal cortex are common in the fat around the gland and may also lie near the kidney or along the path of the gonads; under high ACTH, as in congenital adrenal hyperplasia, testicular rests can enlarge
Development
One gland, two origins: the cortex forms from coelomic mesoderm near the root of the mesentery, and neural crest cells move into it to become the medulla. At birth the gland is relatively large because of a thick fetal cortex that shrinks over the first months.
Related conditions
- Cushing syndrome
- Phaeochromocytoma
- Adrenal insufficiency
- Hereditary paraganglioma and pheochromocytoma (SDH)
- X-linked adrenoleukodystrophy
- Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
- Congenital adrenal hyperplasia due to 11β-hydroxylase deficiency
- Congenital adrenal hyperplasia due to 17α-hydroxylase deficiency
- Adrenal crisis
- Primary hyperaldosteronism (Conn syndrome)
- Adrenal incidentaloma
- Adrenocortical carcinoma
- Meningococcal disease (meningococcemia)
- Bartter, Gitelman and Liddle syndromes
- Neuroblastoma
Test yourself
Think of the answer, then tap the question to see it.
Where does the right adrenal vein drain, and why does it matter?
Straight into the back of the inferior vena cava; being very short, it tears easily in right adrenalectomy and is the commonest failure point in adrenal vein sampling.
What lies in front of and behind the right adrenal gland?
In front: the inferior vena cava medially and the bare area of the liver laterally. Behind: the right crus of the diaphragm.
How do sympathetic fibres reach the adrenal medulla?
Preganglionic sympathetic fibres (T10–L1, via splanchnic nerves) synapse directly on the medullary chromaffin cells, with no ganglion in between.
What is Waterhouse–Friderichsen syndrome?
Bilateral adrenal hemorrhage, as in meningococcal sepsis, causing acute adrenal failure.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- glandula suprarenalis TA2 3874
- Official Spanish (DeCS)
- Glándulas suprarrenales DeCS D000311
- English (TA2)
- Suprarenal gland
- Also called
- adrenal gland · adrenal glands · corpus suprarenale · right suprarenal gland
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis: Adrenal Glands (Suprarenal Glands); 17.11 Development and Aging of the Endocrine System (OpenStax (Rice University), 2022) · adapted, CC BY 4.0; Anatomy of the Human Body (20th ed.): The Chromaphil and Cortical Systems (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.
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Representative model, for educational purposes only.