Case Report: Adrenal Haemorrhage: Clinical Presentation And Ultrasound Diagnosis In A Nigerian Newborn

Abstract

Neonatal Adrenal Haemorrhage (NAH) is a rare condition resulting from a variety of aetiological factors. It has a potential for a catastrophic outcome, thus underscoring the need for a high index of suspicion and a reliable/accurate method of diagnosis. This case report is to alert on the diagnostic possibility of NAH and usefulness of ultrasound diagnosis in the evaluation of a neonate with severe anaemia, non-physiologic hyperbilirubinaemia and abdominal mass.

The subject was a 25 hour old male newborn who was managed for 15 days. He presented with severe anaemia and sepsis for which an exchange blood transfusion was administered. Following a recurrence of the anaemia and palpation of a right hypochondrial mass, he had an abdominal ultra sound evaluation that revealed a 3.47cm by 2.9cm echogenic right supra renal mass. This subsequently became echolucent on serial ultrasonography, presumably following liquefaction. The mass shrunk significantly over the next 15 days with regenerative changes following a period of conservative management. There was no adverse outcome. Final assessment was that of NAH complicated by severe recurrent anaemia and non-physiological hyperbilirubinaemia. The clinical presentation and value of ultrasound diagnosis are discussed.

Key Words: Neonate, Adrenal Haemorrhage, Ultrasound

Nigerian Journal of Clinical Practice Vol.7(2) 2004: 93-96