Neonatal adrenal hemorrhage presenting as an acute scrotum: A case report on the rare presentation of right adrenal hemorrhage and contralateral left scrotal hematoma

Abstract

Introduction: Acute swelling and discoloration of the scrotum in a newborn is a rare condition and can have several causes such as testicular torsion, trauma, inguinal hernia, hydrocele, or adrenal hemorrhage. Case presentation: We report a neonate of adrenal hemorrhage presenting clinically as the acute scrotum. Definitive diagnosis was defined by ultrasonography and computed tomography scan, and the conservative management was successfully performed. Conclusion: Adrenal hemorrhage should be considered as one of the causes of acute scrotum in newborns. The abdominal ultrasonography, as well as the scrotal ultrasonography, should be performed routinely to achieve a definitive diagnosis to avoid unnecessary invasive procedures.

Editorial comment from Dr. Alonso, Dr. Perez‐Bertolez, and Dr. Castro to neonatal adrenal hemorrhage presenting as an acute scrotum: A case report on the rare presentation of right adrenal hemorrhage and contralateral left scrotal hematoma

“…Editorial comment from Dr. Alonso, Dr. Perez-Bertolez, and Dr. Castro to neonatal adrenal hemorrhage presenting as an acute scrotum: A case report on the rare presentation of right adrenal hemorrhage and contralateral left scrotal hematoma Neonatal adrenal hemorrhage (NAH) is an infrequent condition (1.7-2.1/1000 births). 1 It is more common in boys and on the right side (70%) as in the case reported by Okamoto et al, 2 where it can be compressed between the liver and spine. It is remarkable that adrenal glands in newborns are approximately 10-20 times bigger in comparison with adults relative to body weight, increasing their vulnerability.…”

“…It is remarkable that adrenal glands in newborns are approximately 10-20 times bigger in comparison with adults relative to body weight, increasing their vulnerability. 1 As it is explained by these authors, 2 NAH is associated with difficult delivery, shock, septicemia, coagulopathy, and any factor leading to hypoxia and redistribution of blood toward the central nervous system, heart, and adrenal gland. Spontaneous and prenatal occurrences are also documented.…”

“…As it is explained by these authors, 2 NAH is associated with difficult delivery, shock, septicemia, coagulopathy, and any factor leading to hypoxia and redistribution of blood toward the central nervous system, heart, and adrenal gland. Spontaneous and prenatal occurrences are also documented.…”

“…Neonatal adrenal hemorrhage (NAH) is an infrequent condition (1.7–2.1/1000 births) 1 . It is more common in boys and on the right side (70%) as in the case reported by Okamoto et al., 2 where it can be compressed between the liver and spine. It is remarkable that adrenal glands in newborns are approximately 10–20 times bigger in comparison with adults relative to body weight, increasing their vulnerability 1 …”