All issues > Volume 47(5); 2004

Original Article

Korean J Pediatr. 2004;47(5):535-542. Published online May 15, 2004.

A Clinical Study and Sonographic Findings of Neonatal Adrenal Hemorrhage

Ok Yeon OY Cho¹, Kyoung Eun KE Lee¹, Eun Jung EJ Shim¹, Do Jun DJ Cho¹, Dug Ha DH Kim¹, Ki Sik KS Min¹, Ki Yang KY Yoo¹, Kwan Sub KS Lee²

¹Department of Pediatrics, College of Medicine, Hallym University, Chunchon, Korea
²Department of Radiology, College of Medicine, Hallym University, Chunchon, Korea

Correspondence Dug Ha DH Kim ,Email: dougkim@hallym.or.kr

Abstract

Purpose
: This study was performed to present out experience of neonatal adrenal hemorrhage (NAH) and to help diagnosis and management of NAH.
Methods
: We conducted a retrospective study on 14 neonates diagnosed as NAH from January 1993 to August 2002 at Hallym Medical Center. Their clinical manifestations, risk factors, sonographic findings and progression of NAH were evaluated using medical records.
Results
: There were 12 male cases and two female cases. All cases were full-term babies. In terms of method of delivery, there were 13 cases of vaginal delivery and one case of cesarean section. The most common symptom was jaundice(10 cases). Poor feeding, vomiting, anemia, scrotal swelling with bluish discoloration, abdominal distension and cyanosis were also noted. The risk factors included perinatal asphyxia(five cases), large baby(three cases), sepsis(one case) and birth trauma(one case). Twelve cases(85.7%) involved the right adrenal gland, one case(7.1%) the left side and one case(7.1%) bilateral. In abdominal sonography, hemorrhage was seen as an isoechoic mass with central anechoic portion(35.7%), a central hypoechoic mass with peripheral hyperechoic portion(28.6 %), an anechoic cystic mass(28.6%) and a heterogeneous hyperechoic mass(7.1%). Only a conservative treatment was sufficient in all cases. In the 12 cases(85.7%) followed up, size of hemorrhage was reduced in repetitive sonography without any complications.
Conclusion
: The review of these patients emphasizes the subtle and diverse clinical presentation of adrenal hemorrhage in neonates and stresses the importance of repetitive abdominal sonography in establishing the diagnosis.

Keywords :Neonatal adrenal hemorrhage