Hosting 718 files, 2916 images, and 4 contributors.

 
Random Case

Neurofibromatosis with pathologic fracture
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Adrenal Hemorrhage - 1

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 5 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: US CR
Activities:
Adobe32 PDF Imagej32 ImageJA

History

Newborn with depression.


Case Images


Diagnosis

Adrenal Hemorrhage

Findings

US – Avascular right suprarenal mass.

CR – Radiograph with magnification several months later shows development of right suprarenal calcification.

Discussion

Clinical manifestations of adrenal hemorrhage can vary from an asymptomatic isolated focal unilateral adrenal hemorrhage to shock from massive bilateral adrenal hemorrhage. Palpable flank mass, anemia, jaundice, scrotal hematoma and Addisonian crisis may also be present. Most hemorrhages are right-sided. Fifty to sixty arterial branches from three suprarenal arteries supply each gland through a subcapsular plexus. This highly vascular plexus drains into medullary sinusoids via relatively few venous channels, thereby creating a potential “vascular dam.” Any condition leading to hypoxia may lead to shunting of blood flow to vital organs. Furthermore in times of physiologic stress, endogenous adrenocorticotropic hormone release further increases blood flow rates to critical organs by several folds resulting in hemorrhage into the gland. Hypoxia also causes damage to the endothelial cells, making them more prone to hemorrhage. Predisposing factors include birth asphyxia, birth trauma, septicemia, underlying tumor, and hypoprothrombinemia.

Reference

Qureshi UA, Ahmad N, Rasool A, et al. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice. J Indian Assoc Pediatr Surg. 2009 Oct-Dec; 14(4): 221–223.



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare