Korean J Urol.  2007 Jul;48(7):757-760. 10.4111/kju.2007.48.7.757.

Neonatal Adrenal Hemorrhage Presenting as Acute Scrotum

• Kim S
• Oh JR
• Kim JB
• Lee SH
• Lee SK
• Hwang IK
• Namkung S
• Bae EJ

• KMID: 1990232
• DOI: http://doi.org/10.4111/kju.2007.48.7.757

Abstract

There has been only 23 cases of neonatal adrenal hemorrhage presenting as an acute scrotum and unnecessary surgical exploration was performed in nine of these case(39%) due to suspected testicular torsion. We report here on a case of a 2-day-old boy with neonatal adrenal hemorrhage, and he presented with an acute scrotum; this child's condition was managed conservatively.

Keyword

Neonate; Adrenal glands; Hemorrhage; Scrotum

MeSH Terms

Adrenal Glands
Hemorrhage*
Humans
Infant, Newborn
Male
Scrotum*
Spermatic Cord Torsion

Figure

• 

  Fig. 1. Swelling and discoloration of the right groin and scrotum.

• 

  Fig. 2. The scrotal (A) and transabdominal (B) ultrasonography demonstrated a right testis (T) with surrounding hematoma (H) and a retroperitoneal hematoma (R) above the right kidney (K).

• 

  Fig. 3. Magnetic resonance imaging demonstrated a retroperitoneal hematoma (H) with low, heterogeneous signal intensity on the T2-weighted image (A), and this was not enhanced on the contrast enhanced T1-weighted image (B).

Reference

References

1. Black J, Williams DI. Natural history of adrenal hemorrhage in the newborn. Arch Dis Child. 1973; 48:183–90.

2. Adorisio O, Mattei R, Ciardini E, Centonze N, Noccioli B. Neonatal adrenal hemorrhage mimicking an acute scrotum. J Perinatol. 2007; 27:130–2.

3. Avolio L, Fusillo M, Ferrari G, Chiara A, Bragheri R. Neonatal adrenal hemorrhage manifesting as acute scrotum: timely diagnosis prevents unnecessary surgery. Urology. 2002; 59:601.

4. Giacoia GP, Cravens JD. Neonatal adrenal hemorrhage presenting as scrotal hematoma. J Urol. 1990; 143:567–8.

5. Karpe B, Nybonde T. Adrenal hemorrhage versus testicular torsion-a diagnostic dilemma in the neonate. Pediatr Surg Int. 1989; 4:337–40.

6. Putnam MH. Neonatal adrenal hemorrhage presenting as a right scrotal mass. JAMA. 1989; 261:2958.

7. Amoury RA, Barth GW, Hall RT, Rhodes PG, Holder TM, Ashcraft KW. Scrotal ecchymosis: sign of intraperitoneal hemorrhage in the newborn South Med J. 1982; 75:1471–5.

8. Choo GY, Chung YG, Kim YJ, Chung JS, Kang SC, Lee T. Bilateral neonatal torsion of testis. Korean J Urol. 2006; 47:794–6.