[Neonatal adrenal hemorrhage. A surgical problem?]

Eight cases of neonatal adrenal haemorrhage are reported, four of which were necropsy findings, two were treated conservatively and the remaining two underwent exploratory and evacuation laparotomy. The four latter patients recovered. Diverse clinical pictures which may be present at the onset of adrenal haemorrhage in newborns are reviewed and particularly the indications for surgery. In this report, one laparotomy was done to establish a differential diagnosis of retroperitoneal mass, and the other after onset of intense hemoperitoneum and signs of hypovolemic shock. Different pathogenic hypotheses about this entity are contemplated, particularly traumas and circumstances surrounding birth; one of the reported cases coincided with a known birth-injury. The various diagnostic methods in use today and their degree of usefulness or risk also come into discussion. Special mention is made about calcifications of the adrenal glands in this disease and they are compared to calcifications found in other pediatric problems.