Radiology Teaching Files > Case 642010

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

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

-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.


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

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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

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