Bilateral adrenal gland enlargement in the setting of acute pain in pregnancy is consistent with either hemorrhage or thrombosis.
In this case, pregnancy did not allow multiphased CT; hence, non-contrast CT was not performed.

However, several clinical and imaging clues facilitated the confident diagnosis of bilateral adrenal thrombosis:

• a past history of 3 miscarriages suspicious for an underlying thrombophilic disease, associated with current pregnancy at 27WG.
• adrenals density was 20HU on average after contrast media administration.
• partial thrombi in the IVC, one closely related to the anatomical junction with the right adrenal gland.