{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:14Z","timestamp":1756318214049,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,22]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>Neonatal adrenal haemorrhage affects approximately 0.17%\u20130.21% of babies, although, usually, it remains asymptomatic, and therefore, the exact incidence is probably greater. The increased vascularity and relatively large size of the adrenal glands in neonates increases their vulnerability to haemorrhage during labour. There have been few cases that have presented with bowel obstruction.<\/jats:p>\n               <jats:p>A term neonate was admitted with bilious vomiting, dehydration and mottled skin. He was afebrile but hypoglycaemic. Dark green aspirations were present on placement of a nasogastric tube, and emergent upper gastrointestinal contrast study demonstrated failure of contrast to pass and deviation of the duodenum. Together these features raised concern of malrotation with volvulus promoting surgical exploration. Intraoperatively, a left suprarenal mass was discovered, causing bowel obstruction. An ileostomy was created, and a biopsy was taken. Adrenal haemorrhage was diagnosed, which is an extremely rare cause of bowel obstruction. Serial ultrasound scans have been done since, showing reduction of the haemorrhage and his ileostomy has been reversed.<\/jats:p>\n               <jats:p>Adrenal haemorrhage is rarely reported to cause bowel obstruction. A neonate with bilious vomiting and an abnormal contrast may represent malrotation; however, adrenal haemorrhage is an uncommon, but important, differential to consider in these scenarios.<\/jats:p>","DOI":"10.1136\/bcr-2024-260907","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T12:10:27Z","timestamp":1730981427000},"page":"e260907","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Neonatal adrenal haemorrhage presenting with bowel obstruction in a term neonate"],"prefix":"10.1136","volume":"17","author":[{"given":"Emily Ann","family":"Bickerstaff","sequence":"first","affiliation":[{"name":"Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Ashour","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fawkner-Corbett","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, Oxford University, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"2025082710532715000_17.11.e260907.1","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.3109\/14767058.2014.976550","article-title":"Adrenal haemorrhage in term neonates: a retrospective study from the period 2001\u20132013","volume":"28","author":"Gyurkovits","year":"2015","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2025082710532715000_17.11.e260907.2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.4038\/jmj.v35i1.185","article-title":"Right adrenal mematoma causing partial small bowel obstruction in a term neonate","volume":"35","author":"Sanseevan","year":"2023","journal-title":"Jaffna Med J"},{"key":"2025082710532715000_17.11.e260907.3","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/BF02387664","article-title":"Intestinal obstruction in a neonate with adrenal hemorrhage and renal vein thrombosis","volume":"19","author":"Levine","year":"1989","journal-title":"Pediatr Radiol"},{"key":"2025082710532715000_17.11.e260907.4","first-page":"43","article-title":"Adrenal bleeding in neonates: report of 37 cases","volume":"53","author":"Demirel","year":"2011","journal-title":"Turk J Pediatr"},{"key":"2025082710532715000_17.11.e260907.5","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1055\/s-2007-994497","article-title":"Ultrasound in screening for neonatal adrenal hemorrhage","volume":"12","author":"Felc","year":"1995","journal-title":"Am J Perinatol"},{"key":"2025082710532715000_17.11.e260907.6","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/BF00185145","article-title":"The deadly vomit: malrotation and midgut volvulus","volume":"2","author":"Millar","year":"1987","journal-title":"Pediatr Surg Int"},{"key":"2025082710532715000_17.11.e260907.7","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/00000658-194909000-00015","article-title":"Intestinal Obstruction in the Newborn","volume":"130","author":"Glover","year":"1949","journal-title":"Ann Surg"},{"key":"2025082710532715000_17.11.e260907.8","unstructured":"British Association of Perinatal Medicine . 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