Lodhia Jay, Sikobizahora Sophie, Gondwe Stephen, Philemon Rune Nathaniel
Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Faculty of Medicine, P.O Box 2240, Moshi, Tanzania.
Pan Afr Med J. 2024 Oct 13;49:39. doi: 10.11604/pamj.2024.49.39.44725. eCollection 2024.
Neonatal adrenal hemorrhage is a rare condition with various risk factors in the pediatric population. Adrenal hemorrhage commonly affects the right side in about 70% of the cases and bilateral in about 10%. It is usually asymptomatic but can cause adrenal insufficiency and sudden death. Neonatal adrenal hemorrhage should be considered even when there are no risk factors, as it can occur spontaneously with unspecific clinical presentations. Ultrasonography can confirm diagnosis, a relatively cheap and safe modality, especially for resource-limited settings. In this case report, we present a two-day-old with progressive scrotal hematoma and inguinal ecchymosis with no risk factors. Magnetic resonance imaging confirmed right adrenal hemorrhage; however, the newborn deteriorated fast, reaching mortality within 24 hours of admission. This case illustrates the importance of recognizing the condition to allow for an evidenced approach, which may include conservative waiting, as unwarranted intervention can have negative outcomes.
新生儿肾上腺出血是儿科人群中一种罕见的病症，存在多种风险因素。肾上腺出血在约70%的病例中通常累及右侧，约10%为双侧受累。它通常无症状，但可导致肾上腺功能不全和猝死。即使没有风险因素也应考虑新生儿肾上腺出血，因为它可无特异性临床表现而自发发生。超声检查可确诊，这是一种相对便宜且安全的检查方式，尤其适用于资源有限的环境。在本病例报告中，我们呈现了一名两天大的婴儿，无风险因素却出现进行性阴囊血肿和腹股沟瘀斑。磁共振成像证实为右侧肾上腺出血；然而，新生儿病情迅速恶化，入院后24小时内死亡。本病例说明了认识该病症以便采取循证方法的重要性，这可能包括保守观察，因为不必要的干预可能会产生负面结果。
