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Renal Cell Carcinoma
Joseph Junewick, MD FACR
over 11 years ago
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Adrenal Hemorrhage - 1

Case Detail

Anatomy: Genitourinary
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: US CR
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Newborn with depression.

Case Images


Adrenal Hemorrhage


US – Avascular right suprarenal mass.

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


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.


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.

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