Adrenal hemorrhage (AH) was identified in 1% of 313 children admitted to the trauma unit with abdominal or thoracoabdominal blunt trauma within a 10-year period (1989-1999). Ultrasound examination was useful as a first diagnostic measure in stable children, but computed tomography (CT) is considered to be a better diagnostic tool. Associated visceral injury is common, and liver trauma was present in all 3 cases. Lesions are mainly right-sided, but left-sided or bilateral injuries have also been reported. A few cases are only recognized during surgery or necropsy. Lower-chest injury was seen in one-half of the cases and can result in severe morbidity. AH should not be considered rare, and the widespread use of CT proves that it is a strong indicator of associated visceral injury.
Two premature infants with abdominal distension, respiratory distress syndrome, and sepsis were initially diagnosed and treated for necrotizing enterocolitis (NEC). After failure of conservative measures, a diagnosis of intussusception was contemplated. This pitfall in the management of NEC, with medical treatment and a poor response, has been increasingly reported.
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