Scrotal hematoma due to neonatal adrenal hemorrhage

Neonatal adrenal hemorrhage mimicking an acute scrotum

“…In all the cases managed surgically, the decision to perform a surgical intervention was based only on the physical examination leading to the suspect of testicular torsion. 8 Surgical intervention showed a normal testis in all cases. Postoperative abdominal ultrasound revealed ipsilateral adrenal hemorrhage in all these babies.…”

“…In the cases managed conservatively, physician's previous experiences suspecting NAH as a cause of scrotal swelling avoided unnecessary surgical exploration. 8,11,21 In other cases, ultrasound study of both the scrotum and abdomen performed before the surgery revealed a fluid collection in the scrotum in association with an ipsilateral Neonatal adrenal hemorrhage O Adorisio et al adrenal hemorrhage avoiding unnecessary surgical exploration. 10,11 In conclusion, adrenal hemorrhage may present as scrotal swelling mimicking an acute scrotum.…”

“…1 Clinical manifestations of NAH are anemia, abdominal mass, jaundice and rarely scrotal swelling with skin discoloration. [8][9][10][11] Usually, if bleeding is moderate, blood remains in the adrenal capsule. A large amount of blood can cause the rupture into the peritoneal cavity or retroperitoneal space.…”

“…Blood reaches the scrotum through a patent processus vaginalis or by dissection of the tissue of the retroperitoneum. 2,8,12 Several authors recommend considering an acute scrotal incident as a possible torsion of the testes and to provide promptly a surgical exploration to improve testicular salvage rates in newborn. 13,14 Testicular torsion in the neonatal period may be either antenatal or perinatal.…”

Letters to the Editor

“…It was detected to have adrenal haemorrhage by a post-operative abdominal ultrasound scan. 3 It is emphasised that an awareness of the condition and a scrotal/abdominal ultrasound helps make the diagnosis and prevent an unnecessary operation. This association should be kept in mind in the clinical scenario of neonatal anaemia, jaundice and acute discoloured scrotum (scrotal haematoma).…”