Wright J E, Bear J W
Aust Paediatr J. 1987 Oct;23(5):305-7. doi: 10.1111/j.1440-1754.1987.tb00278.x.
Adrenal haemorrhage in the newborn, an entity well recognized at autopsy and as a cause of massive haemorrhage, may present as an asymptomatic abdominal mass. Three cases of neonatal adrenal haemorrhage are described and the literature is reviewed. Most of the affected babies were of normal birthweight, full term and with no history of difficult delivery or neonatal asphyxia. Most presented with a flank mass and jaundice. The haemoglobin was not always low. Intravenous urography and sonography were the investigations of choice. The most serious condition in the differential diagnosis is neuroblastoma, but the chance of this presenting in the newborn period with normal catecholamine secretion and no evident metastases is sufficiently rare to justify expectant management. Follow-up physical examination and repeat sonography at 1 month are recommended. This interval is long enough to allow resolution of a mass caused by adrenal haemorrhage.
新生儿肾上腺出血，这一在尸检中被充分认识且为大量出血原因的病症，可能表现为无症状的腹部肿块。本文描述了3例新生儿肾上腺出血病例并对相关文献进行了综述。大多数患病婴儿出生体重正常、足月，且无难产或新生儿窒息史。多数病例表现为侧腹肿块和黄疸。血红蛋白并不总是降低。静脉肾盂造影和超声检查是首选的检查方法。鉴别诊断中最严重的病症是神经母细胞瘤，但在新生儿期出现且儿茶酚胺分泌正常、无明显转移的这种情况极为罕见，足以证明可进行期待性处理。建议在1个月时进行随访体格检查并复查超声。这段时间足够长，足以使由肾上腺出血引起的肿块消退。
