ABSTRACT
CONTEXT: Bluish discoloration and swelling of the scrotum in newborns can arise from a number of diseases, including torsion of the testes, orchitis, scrotal or testicular edema, hydrocele, inguinal hernia, meconium peritonitis, hematocele, testicular tumor and traumatic hematoma. Forty-two cases of scrotal abnormalities as signs of neonatal adrenal hemorrhage were found in the literature. CASE REPORT: We present a case of scrotal hematoma due to adrenal hemorrhage in a newborn. Conservative treatment with clinical follow-up was adopted, with complete resolution within 10 days. The possible differential diagnoses are reviewed and discussed.
CONTEXTO: Edema e coloração azulada do escroto do recém-nascido podem sugerir uma série de doenças, incluindo torção dos testículos, orquite, edema escrotal e testicular, hidrocele, hérnia inguinal, peritonite meconial, hematocele, tumor testicular e hematoma traumático. Quarenta e dois casos de alterações escrotais como sinal de hemorragia da glândula adrenal foram encontrados na literatura. RELATO DE CASO: Apresentamos um caso de hematoma escrotal devido a hemorragia da glândula adrenal em um recém-nascido. O tratamento adotado foi conservador, com acompanhamento clínico, com resolução completa em 10 dias. Os possíveis diagnósticos diferenciais são revisados e discutidos.
Subject(s)
Humans , Infant , Male , Adrenal Gland Diseases/complications , Genital Diseases, Male/complications , Hematoma/etiology , Hemorrhage/complications , Scrotum , Adrenal Gland Diseases , Genital Diseases, Male/diagnosis , Hemorrhage , Risk FactorsABSTRACT
Pain abdomen is a common pediatric complaint that brings patient to the hospital in Nepal. Knowledge about its etiology and frequency helps in its evaluation and management. The present study was undertaken to find out the causes and their frequency of pain abdomen in Nepali children. Children with pain abdomen presenting at the emergency room and pediatric outpatient department of Kathmandu Medical College, Kathmandu from January, 2006 to December 2007 were clinically evaluated and investigated to find out the causes and frequency of their pain abdomen. The outcomes were tabulated and analyzed for interpretation. Of 444 patients attended, 356 completed investigations and came for follow up. Cause of pain abdomen was apparent in 117 (32.9%) only. 91.5% were medical causes, comprising predominantly of diarrheal diseases (28.3%), infantile colic (9.4%), urinary tract infection (7.7%) and acid peptic disease (6.8%). 8.5% causes were related to surgical conditions, which needed operative management. Secondary or extra-abdominal causes were found in 20 cases (17.1%). Pneumonia (2), functional (5), vulvovaginitis (2) and infantile colic (11) were predominant causes. Our study showed that the causes of pain abdomen in children were predominantly medical. Gastroenteritis was the most frequent cause. Secondary causes, including functional and emotional causes were infrequent. Small percentage needing surgical management formed a diagnostic challenge.
Subject(s)
Abdominal Pain/diagnosis , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Female , Follow-Up Studies , Gastroenteritis/complications , Genital Diseases, Female/complications , Genital Diseases, Male/complications , Humans , Infant , Male , Morbidity , Nepal/epidemiology , Retrospective Studies , Urologic Diseases/complicationsABSTRACT
Microlithiasis of the epididymis, which is not associated with epididymal inflammation, is a rare entity that has been infrequently published in the literature. We report, one such case that was incidentally detected in association with prostatic adenocarcinoma.
Subject(s)
Adenocarcinoma/complications , Aged , Epididymis/pathology , Genital Diseases, Male/complications , Humans , Incidental Findings , Lithiasis/complications , Male , Prostatic Neoplasms/complications , Rare DiseasesABSTRACT
OBJECTIVE: To present the spectrum of abnormalities found at endorectal magnetic resonance imaging (E-MRI), in patients with persistent hemospermia. MATERIALS AND METHODS: A review of E-MRI findings observed in 86 patients with persistent hemospermia was performed and results compared with those reported in the literature. Follow-up was possible in 37 of 86 (43 percent) patients with hemospermia. RESULTS: E-MRI showed abnormal findings in 52 of 86 (60 percent) patients with hemospermia. These findings were: a) hemorrhagic seminal vesicle and ejaculatory duct, isolated (n = 11 or 21 percent) or associated with complicated midline prostatic cyst (n = 10 or 19.0 percent); b) hemorrhagic chronic seminal vesiculitis, isolated (n = 14 or 27 percent) or associated with calculi within dilated ejaculatory ducts (n = 2 or 4 percent); c) hemorrhagic seminal vesicle associated with calculi within dilated ejaculatory duct (n = 4 or 7.7 percent) or within seminal vesicle (n = 4 or 7.7 percent); d) non-complicated midline prostatic cyst (n = 6 or 11.5 percent); and e) prostate cancer (n = 1 or 2 percent). Successful treatment was more frequent in patients with chronic inflammatory and/or obstructive abnormalities. CONCLUSION: E-MRI should be considered the modality of choice, for the evaluation of patients with persistent hemospermia.
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Ejaculatory Ducts , Hemospermia/etiology , Magnetic Resonance Imaging/methods , Seminal Vesicles , Cysts/complications , Cysts/diagnosis , Genital Diseases, Male/complications , Genital Diseases, Male/diagnosis , Prostatic Neoplasms/complications , Prostatic Neoplasms/diagnosisABSTRACT
A one-year-old boy was admitted with complaints of swelling in the left inguinoscrotal region and an empty right scrotum since birth. The inguinoscrotum contained two ovoid solid swellings one above the other. The swellings were testes like in feel, size and shape. The diagnosis was transverse testicular ectopia. The case was managed by surgery. Tissue from gonads, the tubular structures and the fallopian tubes were sent for histopathological examination for confirmation. This was a case of an otherwise normal male with transverse testicular ectopia with persistent Muellerian duct syndrome in the left inguinoscrotal hernial sac.
Subject(s)
Choristoma/complications , Genital Diseases, Male/complications , Humans , Infant , Inguinal Canal , Male , Mullerian Ducts/abnormalities , Disorders of Sex Development/complications , Scrotum , Syndrome , TestisABSTRACT
Cuando el pediatra recibe a un paciente con dolor intenso en la zona escrotal, de inicio brusco y al examen verifica aumento de volumen, debe realizar un diagnóstico diferencial rápido para dilucidar si requiere tratamiento médico o debe derivarse a cirugía de urgencia para evitar compromiso vital del testículo. Es de gran ayuda revisar el tema periódicamente para actualizar los conocimientos e incorporar nuevos procedimientos diagnóstico que son de gran utilidad.
Subject(s)
Male , Humans , Child , Pain/etiology , Genital Diseases, Male/complications , Genital Diseases, Male/diagnosis , Scrotum/physiopathology , Testis/physiopathology , Acute Disease , Emergencies , Orchitis/complications , Orchitis/diagnosis , Syndrome , Spermatic Cord Torsion/complications , Spermatic Cord Torsion/diagnosisABSTRACT
Inguinal hernia and symptomatic genital diseases are common surgical problem. Late diagnosis and treatment of these abnormalities can lead to irreversible complications such as intestinal strangulation, infertility and psychosomatic problems. Most of these disorders can be diagnosed during childhood period.As a cross-sectional study, 3205 elementary school boy students have been examined.Abnormalities were detected in 213 children [6.6%]. 78[2.4%] had inguinal hernia, 28[0.9%] had hydrocele, 75[2%] had undescended testis and 25[0.8%] had hypospadiasis. Meanwhile, two cases of epispadiasis, one case of varicocele and three cases of micropenis were also reported. Ambiguous genitalia and apenia were not seen in our subjects. Most of the parents were not alert about their children's anomalies.According to the high incidence of penoscrotal anomalies and low public knowledge, educational and screening programs are recommended
Subject(s)
Humans , Male , Child , Genital Diseases, Male/epidemiology , Cross-Sectional Studies , Genital Diseases, Male/complications , Students , SchoolsSubject(s)
Humans , Male , Female , Infant, Newborn , Adolescent , Adult , Chlamydia Infections/diagnosis , Chlamydia trachomatis/pathogenicity , Trachoma/etiology , Antigens, Bacterial/isolation & purification , Antigens, Bacterial , Chlamydia Infections/complications , Chlamydia Infections/drug therapy , Chlamydia trachomatis/drug effects , Chlamydia trachomatis/isolation & purification , Conjunctivitis, Bacterial/diagnosis , Conjunctivitis, Bacterial/etiology , Genital Diseases, Female/complications , Genital Diseases, Female/diagnosis , Genital Diseases, Female/etiology , Genital Diseases, Male/complications , Genital Diseases, Male/etiology , Sensitivity and Specificity , Serologic Tests , Immunologic Tests/statistics & numerical data , Trachoma/complications , Trachoma/drug therapyABSTRACT
El síndrome de Reiter (SR) está descrito clásicamente como una triada compuesta por artritis, uretritis y conjuntivitis. No obstante, existen casos de SR incompletos y otros que además presentan compromiso mucocutáneo, pleural, pericárdico, inclusi amiloidosis secundaria. A pesar de que su etiología no ha sido establecida con certeza, se sabe que un proceso infeccioso de vías urogenitales o enteral, más una predisposición genética, podrían desencadenar el cuadro. Presentamos a 4 pacientes de sexo masculino, de edades que fluctúan entre los 22 y 36 años. Al momento de consultar, 3 tuvieron antecedentes de uretritis y 2 de un cuadro diarreico agudo. En los 4 casos hubo compromiso poliarticular, siendo más frecuente en rodilla, hombro y cadera. La afección cutánea sucedió en 3 casos: un paciente presentó placas eritematoescamosas en cuero cabelludo, indistinguibles de psoriasis vulgar, y en otrso segmentos del cuerpo, 2 exhibieron la clásica balanitis circinada y uno mostró una lesión peneana eritematosa inespecífica. el compromiso conjuntival estuvo presente en 3 casos. Entre los exámenes de laboratorio destacan el HLA-B27 (+) (2 casos), cifras elevadas de VHS (4 casos) y leucocitosis (2 casos). En 2 casos de afección cutánea se tomó biopsia de la lesión, cuyo estudio histológico reveló hallazgos compatibles con SR. Ningún caso poseía anticuerpos anti VIH. No pudo identificarse agente infeccioso causal de uretritis y/o enteritis, tanto por cultivo como por examen serológico. De todos los casos, uno se trató con bromocriptina, teniendo como respuesta favorable el compromiso auricular, no así el mucocutáneo. Finalmente, hacemos notar que, en ciertos casos de SR con manifestaciones cutáneas, existe una dificultas para el diagnóstico diferencial entre sta patología y la psoriasis
Subject(s)
Humans , Male , Adult , Arthritis, Reactive/diagnosis , Signs and Symptoms , Amyloidosis/etiology , Histocompatibility Antigens , Arthritis, Reactive/complications , Arthritis, Reactive/drug therapy , Arthritis, Reactive/physiopathology , Arthritis/etiology , Conjunctivitis/etiology , Diagnosis, Differential , Genital Diseases, Male/complications , Skin ManifestationsABSTRACT
Se define la ginecomastia como el desarrollo de la glándula mamaria en el hombre. Su frecuencia alcanza aproximadamente al 1% de las consultas en nuestro policlínico especializado. La alteración entre la relación andrógenos-estrógenos ya sea por disminución de los primeros o aumento de los segundos explicaría esta anormalidad. Histológicamente hay una proliferación del sistema ductal sin formación de lobulillos y un crecimiento del estroma. Se describen algunas ginecomastias consideradas fisiológicas: la del recién nacido, la puberal y la del senescente y otras patológicas: como las por administración de medicamentos (algunos llevan a una mayor actividad estrogénica y otros inhiben la síntesis o la acción de la testosterona); asociadas a enfermedades no gonadales (enfermedades hepáticas, fallas renales, desnutrición, endocrinopatías, cáncer pulmonar y otros); de origen gonadal (hermafroditismo verdadero, anorquia congénita, tumores testiculares o daño testicular e hipogonadismo) asociadas a traumatismos torácicos y finalmente, un grupo de etiología desconocida o idiopáticas que constituyen más del 50% de las ginecomastias del adulto. El tratamiento es habitualmente quirúrgico al que se llega fundamentalmente por razones estéticas o de diagnóstico
Subject(s)
Humans , Male , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Genital Diseases, Male/complications , Gynecomastia/etiology , Hypogonadism/complications , Testicular Neoplasms/complications , Androgens/deficiency , Estrogens , Gynecomastia/therapy , Testosterone/biosynthesisABSTRACT
Se comunica el caso de dos pacientes con fascitis necrozante del escroto y pared abdominal, como los informados por Fournier en 1883, con la anatomía, fisiopatología, bacteriologíca y tratamiento del padecimiento con alto riesgo de mortalidad.