Chronic indirect Pb exposure results in lipid peroxidation in erythrocytes of apprentices via OS, and duration of Pb exposure is a reliable marker of Pb toxicity.

A 4220-g male infant was born at 40 weeks' gestation to a 24-year-old mother by spontaneous vaginal delivery. The newborn 1-and 5-minute Apgar scores were 7 and 8, respectively. Scrotal swelling and discoloration were noted 48 hours after birth. Findings of a physical examination showed hypospadias and an enlarged and discolored right hemiscrotum (Figure 1). Ultrasound study of the abdomen revealed a cystic mass (25 × 20 mm) suggesting adrenal hemorrhage on the upper pole of the right kidney (Figure 2; available at www.jpeds.com). Ultrasonography revealed an edematous scrotum with marked thickening of subcutaneous tissue. At age 14 days, the patient's physical examination was normal due to spontaneous recovery. Neonatal adrenal hemorrhage, which occurs in 0.2% of newborns, is more commonly associated with perinatal hypoxia and difficult or traumatic delivery, or it can be spontaneous. 1 Clinical manifestations of neonatal adrenal hemorrhage are variable, depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. 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. 2,3 Scrotal hematoma often raises the suspicion of testicular torsion. However, in an appropriate clinical setting, abdominal ultrasound may confirm the diagnosis of adrenal hemorrhage and avoid unnecessary surgical intervention. 4 This association allows conservative treatment, avoiding unnecessary surgical exploration.