A. Nordwig, S. Jess, H. Hetschko (Halle-Dölau)  

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Newborn  

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Abdomen-Renals  

circulatory  

- Eutrophic newborn
- Complicated spontaneous breech delivery
- Amniotic aspiration with infiltrate in the area of the right lower lung lobe. Uncomplicated course.
- Sonographic screening in the 9th day postpartum  

A suprarenal/adrenal hemorrhage can be found in 2 to 4 cases out of 1000 newborns and can occur prenatally or postnatally. The most important causes are birth trauma, neonatal asphyxia, systemic disorders and newborn sepsis. With 70%, the right adrenal gland is affected more frequently than the left. Bilateral hemorrhage can be occur in about 5 - 10% - in this case, a corticosteroid substitution may be necessary and necessitating longterm follow-up.  

<- view Ultrasound 1

Ultrasound 1: 9th day of life: At the upper pole of the left kidney, a well defined, about 54 x 32 x 34 mm measuring tumor is identified, which displaces the kidney caudally. The tumor contains heterogenous, echogenic and hypoechoic areas. Doppler sonography shows no perfusion.




<- view Ultrasound 2

Ultrasound 2: Normal renal parenchyma in a caudally displaced left kidney.




<- view Ultrasound 3

Ultrasound 3: Follow-up after 19 days postpartum. At the left upper renal pole, a well defined tumor is again identified, which decreased in size (36 x 20 x 24 mm), containing echogenic and hypoechoic areas.

 

Total constellation (Consens)  

connatal neuroblastoma, multicystic nephroblastoma  

The sonographic findings are dependent of time and dependent on the severity of the hemorrhage:

- Echogenic tumor in the first hours after hemorrhage (accordingly to a fresh coagulum)

- Anechoic cystic process after 1 - 2 weeks (liquefied hematoma)

- Decrease in size of the mass with increasing echogenicity and eventually calcification after 4 to 6 weeks.  

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Suprarenal hemorrhage, Adrenal hemorrhage, newborn, suprarenal, adrenal, hemorrhage, adrenal gland, adrenal hemorrhage, child, childhood, pediatric radiology  

A Nordwig, S Jess, H Hetschko. Adrenal hemorrhage in a Newborn. PedRad [serial online] vol 4, no. 1.
URL: www.PedRad.info/?search=20040105194544