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Two neonates presented to our service with suspected intraabdominal surgical emergencies. Both subsequently were found to have hepatoadrenal necrosis due to overwhelming echoviral infection. Echovirus types 11 and 12 were isolated postmortem. The latter virus has not been associated previously with fulminant neonatal illness.
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Adrenal calcification occurred in 52.6% of rhesus monkeys, 4.7% of cynomolgus monkeys and 2.4% of baboons examined. In contrast, ovarian calcification was observed in 62.3% of baboons, 38% of cynomolgus and 22.3% of rhesus monkeys examined.
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Massive adrenal haemorrhage in the newborn frequently presents as an abdominal mass and is difficult to diagnose when this is the sole clinical feature. Surgery is indicated for the diagnosis and treatment of those cases in which a malignant tumour cannot be ruled out from the X-ray appearance with certainty. 3 cases are discussed in respect to clinical signs and the differential diagnosis of adrenal calcification in infancy is briefly mentioned in this connexion.
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Four neonates with abdominal masses following adrenal hemorrhages were investigated by renal scintigraphy. Characteristic photon-deficient lesions were noted in the suprarenal areas during the phase of whole-body radionuclide distribution.
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The control of hormone secretion and substrate uptake by the thyroid and inner adrenal cortex is similar because both glands undergo hypothalamic-pituitary trophic hormone modulation and negative feedback by their respective major secretory products: thyroid hormone and cortisol, respectively. As a result of these parallel mechanisms of endocrine function, thyroidal accumulation of radioiodine or Tc-99m pertechnetate and adrenal cortical accumulation of I-131-6 beta-iodomethylnorcholesterol (NP-59) and other radiocholesterol analogs are strikingly similar. The patterns of imaging of these glands are thus functional maps of the process(es) of substrate accumulation and depict the endocrine pathophysiology of these glands in a variety of dysfunctional states. The well-recognized patterns of thyroid imaging can be shown analogous to those of the adrenal cortex.
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Our experience on 371 patients studied with DSA for reno-adrenal pathology in the last two years is reported. The purpose of this study was the evaluation of real possibilities of DSA in comparison with conventional angiography, particularly to specify diagnostic space of venous versus arterial approach in this region of interest. In our experience, DSA by venous approach is indicated only as a screening method for nefrovascular hypertension or post-surgery, post-PTA and post-embolization controls; in all other cases, DSA by arterial approach is preferable for its superior diagnostic accuracy and lesser pharmacological invasivity, in comparison both with venous DSA and conventional angiography.
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