Assessment of diagnostic methods in adrenal gland hemorrhage in neonates on the basis of own material from the years 2007-2011

We analyzed a group of nine neonates diagnosed with adrenal gland hemorrhage in the years 2007-2011, to evaluate diagnostic methods. We assessed risk factors and factors predisposing to hemorrhage. Severe and moderate perinatal hypoxia was found in 5 cases, while sepsis in 4 cases. Three patients had bilateral adrenal hemorrhage. All patients underwent ultrasound examination and color Doppler US. Their levels of vanillyl-mandelic acid in 24-h urine collection were normal. A complete regression of changes without evidence of adrenal hemorrhage or vascular flow on color Doppler US was found in the period from the 20th to the 165th day of life. Conclusions: 1. Color Doppler ultrasound findings, observation of the evolution of changes and a lack of vascular flow in adrenal glands, are suggestive of bleeding. Color Doppler ultrasound seems to be the most important diagnostic method. 2. The level of urinary catecholamine metabolites (vanillyl-mandelic acid) does not fulfill the role of screening test for neuroblastoma. However, increased levels of these metabolites may suggest a diagnosis other than the adrenal hemorrhage