title: Contribution of surgical evacuation of a large subgaleal hematoma to the resolution of severe conjugated hyperbilirubinemia in a neonate. Case report.
abstract: Subgaleal hematomas (SGHs) in neonates may result from trauma to the scalp sustained during delivery. In the majority of cases, these lesions will resolve on their own without serious or long-term consequences. The authors report on a case of SGH resulting in hypotension, anemia, coagulopathy, and eventually direct hyperbilirubinemia in a neonate. After several weeks of medical management failed to resolve the hyperbilirubinemia, surgical evacuation of the clot was undertaken and yielded favorable results. The direct bilirubinemia in this case was believed to be the result of an overload of iron to the hepatocytes. It is the authors' contention that the evacuation of the hematoma resulted in a reduction in the amount of iron being presented to the liver for metabolism and significantly contributed to this patient's recovery.
authors.affiliation: Medical Scientist Training Program, University of Alabama School of Medicine, Birmingham, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Ryan
authors.forename: Reed A
authors.initials: RA
authors.lastname: Dimmitt
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: O Adetola
authors.initials: OA
authors.lastname: Roberts
authors.forename: Hanseek
authors.initials: H
authors.lastname: Choi
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
mesh_terms: D000740:Anemia / Q000209:etiology; D001720:Birth Injuries / Q000601:surgery*; D001778:Blood Coagulation Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000601:surgery*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000209:etiology / Q000628:therapy*; D007022:Hypotension / Q000209:etiology; D007231:Infant, Newborn; D019190:Iron Overload / Q000209:etiology; D012535:Scalp / Q000293:injuries*; D013396:Suction; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects