Ultrasound Interactive Case Study: Adrenal, enlarged, fetalCase presentation
by: Dr. Wolfgang Moroder - March, 1999
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Today I scanned a patient at 36 wks with moderate polihydramnion. The fetus
showed a dilated stomach, and dilated proximal bowl (jejunum), no ascites, no other abnormalities, normal biophysical
profile, normal Doppler mapping. Fetal caryotyping has been done at 16 wks since the mother is a carrier of balanced translocation and was caryotyped because of recurrent miscarriages. The same balanced translocation was found in the fetus (uniparental disomies were not ruled out). This looked to me like a bowel obstruction but what puzzled me most is the left adrenal gland which appeared quite oversized being 26 mm in the antero-posterior diameter and 20 mm in the transverse. I've never seen such an adrenal and I wonder if it could be due to the stress elicited by pain of the fetus. Unfortunately I cannot send you a video clip on which you can see that the more cranial part of the adrenal looks normal whereas if you scan more caudally the adrenal enlarges up to 20 mm in the transverse diameter as you can see on the first image |
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(right adrenal) |
| Comments: |
| Interesting picture. If the enlargement were stress related why would only
the left be enlarged? I also don’t see the usual cortex and medulla of the adrenal. This makes me wonder could
it be the spleen? It seems posterior to the stomach and similar to spleen in echodensity. Did you see the spleen
separately? Josh Copel Joshua.Copel@Yale.edu |
