[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Left adrenal gland [Endocrine system](https://durgical.com/en/anatomy/system/endocrine-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Left adrenal gland The left adrenal gland is a small gland on top of the left kidney, near the aorta; it makes cortisol, aldosterone and adrenaline. Official name: Suprarenal gland [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=adrenal_gland_left&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A crescent-shaped gland along the upper inner edge of the left kidney. ## What it does Makes the same hormones as the right one. Its vein drains into the left renal vein. ## Key points - Its long vein runs down into the [left renal vein](https://durgical.com/en/anatomy/right-renal-vein/), so left adrenal vein sampling is usually easier than right - Adrenal vein sampling in primary aldosteronism (Conn syndrome) separates a one-sided adenoma, which surgery can cure, from bilateral hyperplasia - Cortex and medulla differ in origin: a pheochromocytoma arises in the medulla; Conn and Cushing adenomas in the cortex ## Key facts **Where** Retroperitoneal on the medial border of the left kidney above the hilum, inside renal fascia; crescent-shaped, behind the stomach (lesser sac) and pancreas, beside the aorta **Blood supply** Superior (inferior phrenic), middle (aorta) and inferior (renal) suprarenal arteries; one vein into the left renal vein **Nerve** Preganglionic sympathetic fibres (T10–L1, via [splanchnic nerves](https://durgical.com/en/anatomy/greater-thoracic-splanchnic-nerve/)) 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** [Stomach](https://durgical.com/en/anatomy/stomach/) across the lesser sac above; body of the [pancreas](https://durgical.com/en/anatomy/pancreas/) and the [splenic artery](https://durgical.com/en/anatomy/splenic-artery/) and vein below **Behind** Left crus of the [diaphragm](https://durgical.com/en/anatomy/diaphragm/) **Medial** [Abdominal aorta](https://durgical.com/en/anatomy/abdominal-aorta/) and the left celiac ganglion **Lateral** Upper medial border of the left [kidney](https://durgical.com/en/anatomy/kidney/), down to near the hilum ## How to find it Not palpable. In surgery it is reached by moving the [spleen](https://durgical.com/en/anatomy/spleen/) and the tail of the pancreas forward and medially, or from behind; its vein, followed up from the left renal vein, leads to it. ## On imaging On CT it looks like an inverted Y or V. A smooth nodule with low attenuation on non-contrast CT (10 HU or less) is typical of a lipid-rich adenoma; larger, heterogeneous or growing masses need further study. Chemical-shift MRI shows signal loss in adenomas. ## 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 - Incidentalomas are tested for hormone excess (cortisol, aldosterone, catecholamines) and judged on size and imaging features - In pheochromocytoma surgery the adrenal vein is tied early to limit the catecholamine surge from handling the tumour - In left adrenalectomy the longer vein is easier to control than on the right, but the pancreas tail and splenic vessels lie close ## Anatomical variants - Accessory cortical nodules are often found in the connective tissue around the gland; after bilateral adrenalectomy for ACTH-dependent Cushing disease, a missed nodule can keep making cortisol ## Development The cortex comes from mesoderm (coelomic epithelium); the medulla from neural crest cells, the source of pheochromocytoma and, in children, neuroblastoma. ## Memory aid Cortex from outside in, "GFR – salt, sugar, sex": glomerulosa (aldosterone), fasciculata (cortisol), reticularis (androgens). ## Related conditions - [Cushing syndrome](https://durgical.com/en/conditions/cushing-syndrome/) - [Phaeochromocytoma](https://durgical.com/en/conditions/phaeochromocytoma/) - [Adrenal insufficiency](https://durgical.com/en/conditions/adrenal-insufficiency/) - [Hereditary paraganglioma and pheochromocytoma (SDH)](https://durgical.com/en/conditions/hereditary-paraganglioma-and-pheochromocytoma/) - [X-linked adrenoleukodystrophy](https://durgical.com/en/conditions/x-linked-adrenoleukodystrophy/) - [Congenital adrenal hyperplasia due to 21-hydroxylase deficiency](https://durgical.com/en/conditions/congenital-adrenal-hyperplasia-due-to-21-hydroxylase-deficiency/) - [Congenital adrenal hyperplasia due to 11β-hydroxylase deficiency](https://durgical.com/en/conditions/congenital-adrenal-hyperplasia-due-to-11-hydroxylase-deficiency/) - [Congenital adrenal hyperplasia due to 17α-hydroxylase deficiency](https://durgical.com/en/conditions/congenital-adrenal-hyperplasia-due-to-17-hydroxylase-deficiency/) - [Adrenal crisis](https://durgical.com/en/conditions/adrenal-crisis/) - [Primary hyperaldosteronism (Conn syndrome)](https://durgical.com/en/conditions/primary-hyperaldosteronism/) - [Adrenal incidentaloma](https://durgical.com/en/conditions/adrenal-incidentaloma/) - [Autoimmune polyendocrine syndromes (APS-1, APS-2) and IPEX](https://durgical.com/en/conditions/autoimmune-polyendocrine-syndromes-and-ipex/) - [Adrenocortical carcinoma](https://durgical.com/en/conditions/adrenocortical-carcinoma/) - [Meningococcal disease (meningococcemia)](https://durgical.com/en/conditions/meningococcal-disease/) - [Bartter, Gitelman and Liddle syndromes](https://durgical.com/en/conditions/bartter-gitelman-and-liddle-syndromes/) - [Neuroblastoma](https://durgical.com/en/conditions/neuroblastoma/) ## Test yourself Think of the answer, then tap the question to see it. ## Where does the left adrenal vein drain? Into the left renal vein; it is long, so left adrenal vein sampling and control at left adrenalectomy are usually easier than on the right. ## Which hormones does each zone of the adrenal cortex make, from outside in? Zona glomerulosa: aldosterone; zona fasciculata: cortisol; zona reticularis: androgens. The medulla makes adrenaline and noradrenaline. ## What is the embryological origin of the adrenal cortex and medulla? Cortex from mesoderm (coelomic epithelium); medulla from neural crest cells, the source of pheochromocytoma and, in children, neuroblastoma. ## Why is adrenal vein sampling done in primary aldosteronism (Conn syndrome)? To separate a one-sided adenoma, which surgery can cure, from bilateral hyperplasia. ## Which CT feature is typical of a lipid-rich adrenal adenoma? A smooth nodule with low attenuation on non-contrast CT (10 HU or less); larger, heterogeneous or growing masses need further study. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/suprarenal-gland/) 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 · left suprarenal gland ## Related - [Kidneys](https://durgical.com/en/anatomy/kidney/) - [Adrenal arteries](https://durgical.com/en/anatomy/middle-suprarenal-artery/) - [Inferior phrenic arteries](https://durgical.com/en/anatomy/inferior-phrenic-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=314); [Anatomy, Abdomen and Pelvis: Adrenal Glands (Suprarenal Glands)](https://www.ncbi.nlm.nih.gov/books/NBK482264/); Anatomy of the Human Body (20th ed.): The Chromaphil and Cortical Systems (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/suprarenal-gland/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/suprarenal-gland/