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Neonatal adrenal haemorrhage with contralateral scrotal haematoma and inguinal ecchymosis
  1. Benjamin Wei-Liang Ng1,2,
  2. Vichard Lim2,
  3. Aiza Hazima Aizulkamal3 and
  4. Vengkatarao Ramanaidu3
  1. 1Faculty of Medicine, SEGi University, Kota Damansara, Selangor, Malaysia
  2. 2Department of Paediatrics, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
  3. 3Department of Diagnostic Imaging, Sibu Hospital, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
  1. Correspondence to Dr Benjamin Wei-Liang Ng; benng85{at}gmail.com

Abstract

Neonatal adrenal haemorrhage (NAH) is more frequently described in neonates due to their relatively larger size and increased vascularity. While most are asymptomatic, they can present with anaemia, jaundice, abdominal mass, scrotal haematoma or more severe complications such as shock and adrenal insufficiency. Scrotal haematoma seen with NAH may be mistaken for other more serious conditions causing acute scrotum. Prompt sonographic examination that includes the bilateral adrenal glands may help to detect NAH early and to avoid unnecessary interventions. Cases of NAH causing ipsilateral inguinal ecchymosis and scrotal haematoma have been reported, but contralateral haematomas are very rare. In this report, we present a unique case of a neonate with an antenatally acquired adrenal haematoma complicated with an acute peripartum rebleeding manifesting as a contralateral scrotal haematoma and inguinal ecchymosis. The NAH was treated conservatively and resolved on follow-up imaging.

  • Neonatal health
  • Adrenal disorders

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BW-LN was responsible for drafting of the text, sourcing and editing the clinical images and investigation results as well as for the critical revision for important intellectual content. VL and AHA were responsible for drafting of the text and critical revision for important intellectual content. VR was responsible for sourcing and editing the clinical images and for critical revision for important intellectual content. The following authors gave final approval of the manuscript: BW-LN, VL, AHA and VR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.