|
Author Affiliations: Department of Neonatology (Mutlu M, Aslan Y), Department of Pediatric Endocrinology (Karag¨¹zel G, Ökten A), and Department of Radiology (Cansu A), Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
Corresponding Author: Mehmet Mutlu, Department of Pediatrics, Karadeniz Technical University, Faculty of Medicine Trabzon, Turkey (Tel: 0462 377 5568; Email: drmehmetmutlu38@hotmail.com)
doi: 10.1007/s12519-011-0259-7
Background: Adrenal hemorrhage (AH) is a relatively uncommon condition in neonates. This study aimed to review the clinical, laboratory and ultrasonographic findings of AH in newborns.
Methods: The medical records of 13 newborns with AH who had been admitted to our neonatal intensive care unit were retrospectively reviewed.
Results: Of the 13 newborns with AH, 8 (62%) were term and 10 (77%) were male babies. Clinical presentations included neonatal jaundice (85%), paleness and/or flank mass (38%), discoloration of the scrotum (15%), and hypotonia/lethargy or hypotension (8%). Five newborns had anemia and four had adrenal insufficiency. Adrenal insufficiency was observed in 80% of the premature infants with AH. AH occurred on the right side in 9 patients (69%). The most predisposing cause of AH was disseminated intravascular coagulation secondary to sepsis or perinatal hypoxia in preterm infants, and large for gestational age in term infants. Ultrasonography (USG) revealed a hypoechoic mass in 7 newborns (54%), a mixed solid-liquid mass in 5 (38%), and an echogenic mass (8%) in 1. Hemorrhage disappeared within 8.6¡À4.5 (4-16) weeks.
Conclusions: AH occurs in the newborns with unexplained jaundice. Adrenal insufficiency is more frequent in preterm than in mature infants. Abdominal USG is required to determine AH in a newborn with swelling and bluish discoloration of the scrotum. Serial USG is the best modality for monitoring AH to prevent unnecessary surgery.
Key words: adrenal hemorrhage; newborn; ultrasonography
World J Pediatr 2011;7(4):355-357
|
