Adrenal hemorrhage in a newborn

Arebu T. Abdu, Vesna M. Kriss, Henrietta S. Bada, Eric W. Reynolds

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations

Abstract

Sometimes in the course of care in a neonatal intensive care unit, there may be a rush to intervene in cases where limited intervention is actually the correct course. One such example is that of neonatal adrenal hemorrhage. We present the case of a male term neonate with shock, metabolic acidosis, distended abdomen, and falling hematocrit. His prenatal and delivery histories were uneventful except for a nuchal cord. Apgar scores were 9 and 9. Because of his dramatic presentation, certain members of the medical team suggested immediate surgical intervention. However, a calm and careful evaluation revealed the true diagnosis and course of action. Ultrasound of the abdomen showed a mass between the liver and kidney, but the origin was difficult to identify. A computed tomography scan supported the diagnosis of right adrenal hemorrhage. His serum cortisol level was normal. The patient was managed conservatively and discharged home after a 1-week stay in the hospital. Subsequent abdominal ultrasound showed resolving adrenal hemorrhage with minimal calcification. A review of the pertinent literature is presented. Physicians should remember adrenal hemorrhage when evaluating a newborn infant with shock, acidosis, abdominal distention, and falling hematocrit and that conservative management is usually indicated.

Original languageEnglish
Pages (from-to)553-557
Number of pages5
JournalAmerican Journal of Perinatology
Volume26
Issue number8
DOIs
StatePublished - 2009

Keywords

  • Abdominal mass
  • Adrenal hemorrhage
  • Hypovolemia
  • Neonatal intensive care
  • Neonate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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