Prolonged jaundice as presenting sign of massive adrenal hemorrhage in newborn. Radiographic diagnosis by IVP with total-body opacification.

Abstract

Abstract The basis of radiographic diagnosis of massive adrenal hemorrhage in newborn infants with abdominal masses and jaundice should be the high-dose intravenous urogram with total-body opacification. This reveals sharply defined avascular adrenal masses, with or without early calcification, that flatten and shift the kidney. Three cases are presented in which jaundice representing hemolysis within a closed space was the striking clinical finding that led to radiographic studies. Differential diagnoses include renal duplication, usually with ectopic ureteroceles, neonatal neuroblastoma, and the rare Wolman's familial xanthomatosis with adrenal calcification.