Adrenal haemorrhage in new born presenting as severe neonatal jaundice

Abstract

Neonatal adrenal haemorrhage is a relatively uncommon. Most often associated with difficult labour, birth trauma, hypoxia, sepsis. Clinical manifestations may vary from asymptomatic to life threatening Addisonian crisis. We present a case of right subacute adrenal hematoma confirmed on MRI abdomen. Risk factor being birth asphyxia. He presented with neonatal jaundice and was managed successfully by conservative methods. Treatment depends on the clinical features and severity. Most of the cases are asymptomatic and managed conservatively. Infants with acute haemorrhage might need urgent blood transfusion. Laparotomy is indicated when haemorrhage seems to be continuing, especially when the exact site of haemorrhage is in doubt. Adrenal haemorrhage usually takes 3 weeks to 6 months to resolve completely. Our case was clinically and hemodynamically stable, so he was managed conservatively and discharged after a week. This case emphasizes the importance high degree of suspicion in evaluation of neonate presented with late onset jaundice and importance of ultrasonography in diagnosis and conservative management.