MyPACS.net: Radiology Teaching Files > Case 642010

never visited ADRENAL HEMORRHAGE IN A NEWBORN
Contributed by: Children's Hospital Omaha, Radiologist, Omaha Childrens, Creighton University and UNMC, Nebraska, USA.
Patient: 5 day old male
History: Newborn with jaundice following difficult delivery
Images:[small]larger

Fig. 1: Sagital image RUQ: Rounded solid isoechoic appearing mass replacing the entire adrenal gland.

Fig. 2: sagital image at 2 weeks of age shows that the a cystic mass with a septation and debris secondary to blood clot lysis and dissolution.
Diagnosis: Adrenal Hemorrhage
Discussion:

-Most common neonatal lesion of adrenal gland
-Causes include: difficult labor/delivery, asphyxia/hypoxia, septicemia, hemorrhagic disorders, ECMO
-Occurs in 1st week of life
-Large for gestational age infants and infants of diabetic mothers are predisposed
-Bilateral in 10%
-U/S: Acutely see a complex solid echogenic mass which becomes of mixed echogenicity with central hypoechogenicity and then anechoic in chronic stage. Peripheral calcifications in 1-2 weeks. Decreases in size over weeks.
-CT: Mass with surrounding fat stranding which beomes low attenuation over time and resembles an adrenal pseudocyst in the chronic stage. Calcifications may be seen in chronic stage.
-Differential diagnosis is neuroblastoma. Follow-up is needed.

References:

Dahnert, Wolfgang. Radiology Review Manual: Fifth Edition. Lippincott, Williams, and Wilkins, 2003.

Submitted by:
Chad Eicher, M.D., Radiology Resident, Creighton University Medical Center
Phillip Silberberg, Omaha Children's Hospital, Omaha, NE
Benjamin Silberberg

Comments:
No comments posted.
Additional Details:

Case Number: 642010Last Updated: 07-26-2006
Anatomy: Genitourinary (GU)   Pathology: Trauma
Modality: USExam Date: 01-01-2000Access Level: Readable by all users
Keywords: adrenal hemorrhage newborn

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.
You can help keep MyPACS tidy: if you notice a case which is not useful (e.g. a test case) or inaccurate, please send email to alert@mypacs.net.