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Neonatal Adrenal Hemorrhage

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Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients

Abstract

Adrenal hemorrhage in newborn may have no clinical signs, while in other cases it may present itself as an abdominal mass; in case of adrenal capsule breaking, clinical symptoms of hemorrhage can be evident, often associated with ipsilateral scrotal hematoma; finally, it can present itself as an endocrine syndrome if adrenal gland failure occurs.

Radiological imaging mostly with ultrasonography (US) plays a key role in the diagnosis of the adrenal masses; it is able to distinguish if the mass belongs to the adrenal gland or kidney. The ultrasonography exam using color Doppler can demonstrate the presence or the absence of a known vascularization into the mass; this is a fundamental criterion in the differential diagnosis with malignant masses as neuroblastoma.

If a further study is needed, the magnetic resonance imaging (MRI) or computed tomography (CT) techniques are able to give a correct answer to the clinical questions and are important to plan surgery.

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References

  • Abdu AT, Kriss VM, Bada HS, Reynolds EW (2009) Adrenal hemorrhage in a newborn. Am J Perinatol 26:553–557

    Article  PubMed  Google Scholar 

  • Adorisio O, Mattei R, Ciardini E, Centonze N, Noccioli B (2007) Neonatal adrenal hemorrhage mimicking an acute scrotum. J Perinatol 27:130–132

    Article  CAS  PubMed  Google Scholar 

  • Alabsi SY, Layland T (2015) Adrenal hemorrhage in neonates: unusual presentation. Neonatal Netw 34:220–226

    Article  PubMed  Google Scholar 

  • Avolio L, Fusillo M, Ferrari G, Chiara A, Bragheri R (2002) Neonatal adrenal hemorrhage manifesting as acute scrotum: timely diagnosis prevents unnecessary surgery. Urology 59:601

    Article  PubMed  Google Scholar 

  • Calisti A, Oriolo L, Molle P, Miele V, Spagnol L (2012) Neonatal adrenal masses: do we have reliable criteria for differential diagnosis and expectant management? Minerva Pediatr 64:313–318

    CAS  PubMed  Google Scholar 

  • Catalano O, Lobianco R, Sandomenico S, Mattace Raso M, Siani A (2004) Real time, contrast-enhanced sonographic imaging in emergency radiology. Radiol Med 108:454–469

    PubMed  Google Scholar 

  • Deeg KH, Bettendorf U, Hofmann V (1998) Differential diagnosis of neonatal adrenal hemorrhage and congenital neuroblastoma by colour coded Doppler sonography and power Doppler sonography. Eur J Pediatr 157:294–297

    Article  CAS  PubMed  Google Scholar 

  • Demirel N, BaÅŸ AY, ZenciroÄŸlu A, TaÅŸci-Yildiz Y (2011) Adrenal bleeding in neonates: report of 37 cases. Turk J Pediatr 53:43–47

    PubMed  Google Scholar 

  • Di Giacomo V, Trinci M, Van der Byl G, Catania VD, Calisti A, Miele V (2015) Ultrasound in newborns and children suffering from nontraumatic acute abdominal pain: imaging with clinical and surgical correlation. J Ultrasound 18:385–393. doi:10.1007/s40477-014-0087-4, Epub 2014 Apr 9

    Article  PubMed  Google Scholar 

  • Eo H, Kim JH, Jang KM, Yoo SY, Lim JH, Kim MJ, Kim OH (2011) Comparison of clinico-radiological features of congenital cystic neuroblastoma and neonatal adrenal hemorrhagic pseudocyst. Korean J Radiol 12:52–58

    Article  PubMed  PubMed Central  Google Scholar 

  • Fadil FZ, Lehlimi M, Chemsi M, Habzi A, Benomar S (2014) Neonatal adrenal hematoma: various modes of presentation. Arch Pediatr 21:990–994

    Article  PubMed  Google Scholar 

  • Farina R, Catalano O, Stavolo C, Sandomenico F, Petrillo A, Romano L (2015) Emergency radiology. Radiol Med 120:73–84

    Article  PubMed  Google Scholar 

  • Gyurkovitz Z, Maroti A, Renes L, Nemeth G, Pal A, Orvos H (2015) Adrenal haemorrhage in term neonates: a retrospective study from the period 2001–2013. J Matern Fetal Neonatal Med 28:2062–2065

    Article  Google Scholar 

  • Jordan E, Poder L, Courtier J, Sai V, Jung A, Coakley FV (2012) Imaging of nontraumatic adrenal hemorrhage. AJR Am J Roentgenol 199:W91–W98

    Article  PubMed  Google Scholar 

  • Kawashima H, Sandler CM, Ernst RD, Takahashi N, Robidoux NA, Goldman SM, Fishman EK, Dunnick NR (1999) Imaging of non traumatic hemorrhage of the adrenal gland. Radiographics 19:949–863

    Article  CAS  PubMed  Google Scholar 

  • Kuhn J, Jewett T, Munshauer R (1971) The clinical and radiographic features of massive neonatal adrenal hemorrhage. Radiology 99:647–652

    Article  CAS  PubMed  Google Scholar 

  • Lau KK, Stoffman JM, Williams S, McCusker P, Brandao L, Patel S, Chan AK, Canadian Pediatric Thrombosis and Hemostasis Network (2007) Neonatal renal vein thrombosis: review of the English-language literature between 1992 and 2006. Pediatrics 120:e1278–e1284

    Article  PubMed  Google Scholar 

  • Meersman A, Wojciechowski M, Vaneerdeweg W, Jorens P, Michiels E, Ramet J (2008) Acute retroperitoneal hemorrhage and shock as presenting signs of neuroblastoma in an infant. Pediatr Emerg Care 24:37–38

    Article  PubMed  Google Scholar 

  • Menichini G, Sessa B, Trinci M, Galluzzo M, Miele V (2015) Accuracy of contrast-enhanced ultrasound in the identification and characterization of traumatic solid organ lesions in children: a retrospective comparison with baseline-US and CE-MDCT. Radiol Med 120:989–1001

    Article  PubMed  Google Scholar 

  • Miele V, Di Giampietro I (2014) Diagnostic imaging in emergency. Salute e Società (2EN):127–138. doi:10.3280/SES2014-002010EN

  • Miele V, Patti G, Cappelli L, Calisti A, Valenti M (1994) Ultrasonography in the diagnosis of neonatal adrenal hemorrhage. Radiol Med 87:111–117

    CAS  PubMed  Google Scholar 

  • Miele V, Galluzzo M, Patti G, Mazzoni G, Calisti A, Valenti M (1997) Scrotal hematoma due to neonatal adrenal hemorrhage: the value of ultrasonography in avoiding unnecessary surgery. Pediatr Radiol 27:672–674

    Article  CAS  PubMed  Google Scholar 

  • Miele V, Galluzzo M, Pedicelli C, Adami L, Calisti A (2000) Neonatal adrenal hemorrhage associated with a scrotal hematoma. Radiol Med 99:299–301

    CAS  PubMed  Google Scholar 

  • Miele V, Di Giampietro I, Ianniello S, Pinto F, Trinci M (2015) Diagnostic imaging in pediatric polytrauma management. Radiol Med 120:33–49

    Article  PubMed  Google Scholar 

  • Miele V, Piccolo CL, Sessa B, Trinci M, Galluzzo M (2016a) Comparison between MRI and CEUS in the follow-up of patients with blunt abdominal trauma managed conservatively. Radiol Med 121:27–37

    Article  PubMed  Google Scholar 

  • Miele V, Piccolo CL, Galluzzo M, Ianniello S, Sessa B, Trinci M (2016b) Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma. Br J Radiol 89(1061):20150823. doi:10.1259/bjr.20150823, Epub 2016 Jan 8

    Article  PubMed  Google Scholar 

  • Miele V, Piccolo CL, Trinci M, Galluzzo M, Ianniello S, Brunese L (2016c) Diagnostic imaging of blunt abdominal trauma in pediatric patients. Radiol Med 121:409–430. doi:10.1007/s11547-016-0637-2, Epub 2016 Apr 13

    Article  PubMed  Google Scholar 

  • Mutlu M, Karagüzel G, Aslan Y, Cansu A, Okten A (2011) Adrenal hemorrhage in newborns: a retrospective study. World J Pediatr 7:355–357

    Article  CAS  PubMed  Google Scholar 

  • Pinto F, Miele V, Scaglione M, Pinto A (2014) The use of contrast-enhanced ultrasound in blunt abdominal trauma: advantages and limitations. Acta Radiol 55:776–784

    Article  PubMed  Google Scholar 

  • Pinto F, Valentino M, Romanini L, Basilico R, Miele V (2015) The role of CEUS in the assessment haemodinamically stable patients with blunt abdominal trauma. Radiol Med 120:3–11

    Article  PubMed  Google Scholar 

  • Rahman S, Ohlsson A, Fong KW, Glanc P (1997) Fetal adrenal hemorrhage in a diamniotic, dichorionic twin: case report and review of controversies in diagnosis and management. J Ultrasound Med 16:297–300

    CAS  PubMed  Google Scholar 

  • Schrauder MG, Hammersen G, Siemer J, Goecke TW, Meurer B, Hart N, Beckmann MW, Schild RL (2008) Fetal adrenal haemorrhage – two-dimensional and three-dimensional imaging. Fetal Diagn Ther 23:72–75

    Article  CAS  PubMed  Google Scholar 

  • Sessa B, Trinci M, Ianniello S, Menichini G, Galluzzo M, Miele V (2015) Blunt abdominal trauma: role of contrast-enhanced ultrasound in the detection and staging of abdominal traumatic lesions compared with US and CE-MDCT. Radiol Med 120:180–189

    Article  PubMed  Google Scholar 

  • Singh J, Dalal P, Bhalla K, Rattan KN (2016) Neonatal adrenal hemorrhage presenting as prolonged hyperbilirubinemia. J Neonatal Surg 10:5–22

    Google Scholar 

  • Velaphi SC, Perlman JM (2001) Neonatal adrenal hemorrhage: clinical and abdominal sonographic findings. Clin Pediatr (Phila) 40:545–548

    Article  CAS  Google Scholar 

  • Westra SJ, Zaninovic AC, Hall TR, Kangarloo H, Boechat MI (1994) Imaging of adrenal gland in children. Radiographics 14:1323–1340

    Article  CAS  PubMed  Google Scholar 

  • Yamamoto K, Hanada R, Kikuchi A, Ichikawa M, Aihara T, Oguma E, Moritani T, Shimanuki Y, Tanimura M, Hayashi Y (1998) Spontaneous regression of localized neuroblastoma detected by mass screening. J Clin Oncol 16:1265–1269

    CAS  PubMed  Google Scholar 

  • Yao W, Li K, Xiao X, Zheng S, Chen L (2013) Neonatal suprarenal mass: differential diagnosis and treatment. J Cancer Res Clin Oncol 139:281–286

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy

    Margherita Trinci, Caterina Maria Trinci, Michele Galluzzo & Vittorio Miele

  2. Department of Pediatric Radiology, Pausilipon Oncologic Pediatric Hospital, Naples, Italy

    Eugenio Rossi & Massimo Zeccolini

Authors
  1. Margherita Trinci
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  2. Caterina Maria Trinci
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  3. Michele Galluzzo
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  4. Eugenio Rossi
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  5. Massimo Zeccolini
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  6. Vittorio Miele
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Corresponding author

Correspondence to Margherita Trinci .

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Editors and Affiliations

  1. Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy

    Vittorio Miele

  2. Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy

    Margherita Trinci

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Trinci, M., Trinci, C.M., Galluzzo, M., Rossi, E., Zeccolini, M., Miele, V. (2016). Neonatal Adrenal Hemorrhage. In: Miele, V., Trinci, M. (eds) Imaging Non-traumatic Abdominal Emergencies in Pediatric Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-41866-7_12

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  • DOI: https://doi.org/10.1007/978-3-319-41866-7_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41865-0

  • Online ISBN: 978-3-319-41866-7

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