Hematoma escrotal como signo infrecuente de hemorragia suprarrenal en recién nacidos

Background: Scrotal hematoma is a rare manifestation of neonatal adrenal hemorrhage (0.2% of newborns). It is commonly associated with perinatal hypoxia, but it can be spontaneous. Blood from the adrenal bed can reach the scrotum through the inguinal canal, explaining this clinical sign. Clinical case: a 24-hour-old male born at term, with adequate weight for his gestational age, presented with bruising and swelling of the right hemiscrotum. Torsion was ruled out in a doppler sonography, identifying a structure compatible with a hematocele. An abdominal ultrasound showed signs of an evolving right adrenal hemorrhage. A conservative management and follow-up with imaging tests were decided. The evolution was favorable and remission was achieved. Conclusions: We highlight the importance of including this entity in the differential diagnosis of acute scrotum, since an ultrasound can prevent an unnecessary surgery in newborns.