Neonatal adrenal hemorrhage as a complication of traumatic vaginal delivery diagnosis and follow up with ultrasonography

Abstract

Adrenal hemorrhage is the most common cause of an adrenal mass in the neonate. The incidence is increased in preterm infants; in prolonged or complicated deliveries. Ultrasound can, in the differential diagnosis of adrenal masses, differentiate solid from cystic masses and those masses arising from the upper pole of the kidney. In this article we wanted to drive the attention of radiologists to the possibility of adrenal hemorrhage in neonates who were born after a complicated vaginal delivery without the specific findings of asphyxia and also to the differential diagnosis of adrenal masses recognized by coincidence. The patient was discharged on the 9th day and followed up in our outpatient clinic. Ultrasonography repeated at 1st and 2nd weeks of discharge showed significant and progressive reduction in the size.

Adrenal kanama yenidoğanda adrenal kitlenin en yaygın nedenlerinden birisidir. Pretermlerde, uzamış ve komplike doğumlarda insidansı artmaktadır. Adrenal kitlenin solid-kistik ayırımında ve ayırıcı tanısında ultrasonografi sıklıkla kullanılmaktadır. Burada asfiktik doğum bulguları olmayan, ko-insidental olarak adrenal kitle saptanan ve ultrasonografi ile kanama tanısı alan bir yenidoğan sunulmaktadır. Hasta izleminin dokuzuncu gününde taburcu edilerek poliklinik izlemine alındı, 1. ve 2. haftalarda yapılan ultrasonografide kitlenin boyutlarında anlamlı azalma saptandı.