Abstract
Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, intrauterine infection, coagulation defects and thromboembolism. It has varied clinical presentation depending on degree of hemorrhage and amount of adrenal cortex compromised by hemorrhage. The most common clinical presentations are persistent jaundice and flank mass. We report a case of left sided adrenal hemorrhage in a breech delivered male neonate with perinatal asphyxia presented with anemia and fever. On further evaluation, he was also having moderate communicating hydrocephalus secondary to intraventricular hemorrhage. The adrenal hemorrhage was managed conservatively. Subsequent abdominal ultrasound showed resolving adrenal hemorrhage. Right ventriculoperitoneal shunt was done for hydrocephalus. Postoperative course was uneventful. The patient is asymptomatic at follow-up.
Highlights
The adrenal gland in neonatal age is vulnerable to hemorrhage because of its large size and high vascularity [1]
Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, intrauterine infection, coagulation defects and thromboembolism
We report a case of left sided adrenal hemorrhage in a breech delivered male neonate with perinatal asphyxia presented with anemia and fever
Summary
The adrenal gland in neonatal age is vulnerable to hemorrhage because of its large size and high vascularity [1]. The incidence of adrenal hemorrhage in detected cases ranges from 1.7 to 2.1 per 1000 births. Because adrenal bleeding may remain asymptomatic, the real occurrence is probably higher [2]. Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, intrauterine infection, coagulation defects and thromboembolism [1,3]. Adrenal hemorrhage usually presents with neonatal jaundice, paleness and/or flank mass, discoloration of the scrotum, anemia and adrenal insufficiency [4,5,6]. We present a rare case of neonatal adrenal hemorrhage having anemia and hydrocephalus
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