Does Urinary Tract Ultrasound have its Place in the Treatment of Early Neonatal Jaundice? Neonatal Bilateral Adrenal Hemorrhage: Case Report

Abstract

SUMMARY – Adrenal hemorrhage is a rare clinical entity in the neonatal period, with an incidence of 1.7-2.1/1000 births. It is more often diagnosed on the right side, whilst bilateral hemorrhage occurs in 10%-15% of cases. Clinical presentation shows a wide range of symptoms, from the signs of adrenal insufficiency to asymptomatic course of illness with incidental finding of changes on testing. Neonatal jaundice due to hemolysis of hemorrhagic content often is an accompanying sign. We present a male neonate born at term, with early neonatal jaundice of unknown cause and without evidence of perinatal infection. Ultrasound of the urinary tract revealed hypoechoic formations in the upper poles of both kidneys, confirmed by magnetic resonance imaging of the abdomen. Clinical and laboratory test results showed no signs of adrenal insufficiency. There was no confirmation of embryonic tumor or neuroblastoma. Ultrasound of the urinary tract as an available and noninvasive test has its place in the treatment of early neonatal jaundice of unknown cause. Additional invasive treatment and unnecessary laparotomy can be avoided with ultrasound monitoring of the formation regression.

Effect of Systematic Holistic Nursing Combined with the MDT Teaching Method in the Nursing of Neonatal Jaundice and Its Impact on the Recovery of the Newborns’ Physiological Function

“…e treatment and rehabilitation of many diseases cannot be completed by a single discipline or major due to their complexity and the specialization of treatment technology, as well as the changes of diagnosis and treatment thoughts. Neonatal jaundice is a common neonatal disease, which is closely related to abnormal bilirubin metabolism, with many causes and extremely complex pathological types [17][18][19][20].…”

Raumforderungen der Nebennieren beim Neugeborenen – sonografische Differenzialdiagnose

“…Die Blutungen treten meist einseitig auf, bei 48,7 % auf der rechten und bei 45,9 % auf der linken Seite, also ohne Bevorzugung einer Seite 1 . Bilaterale Nebennierenblutungen sind selten; sie wurden nur bei 5,4 % aller Nebennierenblutungen gefunden 1 3 .…”

“…Die Neugeborenen fallen meist durch einen palpablen Tumor, einen Ikterus prolongatus (50 %) und eine Anämie (8,1 %) auf 1 . Gelegentlich kann ein Ikterus prolongatus das einzige Symptom einer neonatalen Nebennierenblutung sein 3 .…”