新生儿阴囊血肿（The newborn scrotal hematoma）.doc

新生儿阴囊血肿（The newborn scrotal hematoma） An example of neonatal vitamin K deficiency, which is mainly expressed in cystic hematomas Liu boon du fengrong Classification number: R72 document code: B Male, 3 d after birth, full moon, vaginal birth, due to scrotal swelling 2 d. Body: 36.5 ℃, t. R 40 times/min, HR 140 times/min, weight 3.3 kg, god reaction is good, clear, smooth breathing, body skin sclera moderate yellow dye, lower right abdomen near the groin visible bruises 1 cm x 2.5 cm, the anterior fontanelle flat soft, sensitive bilateral such large such as round pupil light reflex, cardiopulmonary without exception, abdomen is soft, no tenderness and bounce painful, ammonites and liver and spleen, normal bowel sounds, muscle tension is normal, hug, sucking, grip the reflection is normal. The scrotum is obviously swollen and dark purple, but it can reach 3 cm x 5 cm in lump, in medium, fixed, tenderness, and light transmittance. Auxiliary inspection: WBC 10.3 x 109 / L, N 0.626, L 0.282, Hb 165 g/L, RBC 4.98 x 1012 / L, Plt 180 x 109 / L. Thrombin time 68 s was significantly longer than the control 12.5 s, total bilirubin 212.04 umol/L. Admission diagnosis: (1) neonatal anemia; (2) neonatal hyperbilirubinemia. After admission to supplement vitamin K1, stop bleeding and plasma transfusion treatment 2 d, 3 days normal prothrombin time, review of the scrotum hematoma without narrowing, 4 days to higher level hospital examination, abdominal ultrasound and computed tomography (CT) showed the right adrenal hematoma 2 cm * 3 cm, 15 d after hospitalization, scrotal hematoma absorption, adrenal hematoma to 1 cm x 1 cm, clinical cure the hospital. The lack of common expression of neonatal vitamin K is the gastrointestinal hemorrhage, the umbilical cord hemorrhage, intracranial hemorrhage, and the blood of the scrotal hematoma combined with adrenal hematoma is less reported. In this case the vitamin K1 treatment effect is remarkable, 2 d, prothrombin time returned to normal, be