ABSTRACT
Indirect inguinal hernia is the most common congenital anomaly in the pediatric age group. About 15-20% of hernias in infant girls contain ovary, sometimes with a Fallopian tube. The presence of the uterus incarcerated with the adnexa is a very unusual occurrence in female infants with normal kariotype and phenotype, being commonly associated with several disorders of sex development. The surgical repair of this form of hernia is more difficult than a common herniorrhaphy because of the adhesions between the organs and the wall of the sac and the risk of damage during their freeing. We present a rare case of irreducible indirect inguinal hernia containing uterus and bilateral adnexa (fallopian tubes and ovaries) in a premature female infant, discussing the etiopathogenesis and the surgical features of this disorder.
Subject(s)
Adnexa Uteri/pathology , Hernia, Inguinal/diagnosis , Herniorrhaphy , Infant, Premature, Diseases/diagnosis , Uterus/pathology , Female , Hernia, Inguinal/surgery , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/surgeryABSTRACT
The management of acute scrotal swelling can be challenging in neonatal age, with scrotal infections being great mimickers of testicular torsion. Only a few unilateral cases of scrotal abscess have been previously reported, mostly caused by Staphylococcus and Salmonella. We describe the case of a newborn who developed bilateral scrotal abscesses caused by Klebsiella pneumoniae and discuss the rarity of the case, regarding both the bilaterality and the pathogen, never reported before.
Subject(s)
Abscess/diagnosis , Klebsiella Infections/diagnosis , Klebsiella pneumoniae/isolation & purification , Scrotum/microbiology , Testicular Diseases/diagnosis , Abscess/microbiology , Abscess/therapy , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Drainage/methods , Follow-Up Studies , Humans , Infant, Newborn , Klebsiella Infections/therapy , Male , Rare Diseases , Scrotum/physiopathology , Severity of Illness Index , Testicular Diseases/microbiology , Testicular Diseases/therapy , Treatment OutcomeABSTRACT
PURPOSE: Diagnostic laparoscopy has changed the surgical approach to nonpalpable testes (NPT). The aim of this study was to determine the value of laparoscopy in managing patients with NPT and to suggest guidelines for the interpretation of laparoscopic findings. The authors report the results of a multicenter study of the Italian Society of Video Surgery in Infancy on laparoscopic management of NPT. METHODS: Between 1993 and 2001, the authors collected records of 364 patients with NPT who underwent laparoscopy, for a total of 388 testicular units. RESULTS: Intraabdominal testes were found in 124 (34%) cases, for a total of 137 testes; 83 testicular units were classified as low and 54 as high. A total of 155 (43%) patients had cord structures entering the internal inguinal ring, 79 (22%) had intraabdominal blind-ending cord structures, and 6 (1%) had testicular agenesia. CONCLUSIONS: Laparoscopy is a valuable tool in diagnosing and treating more than 50% of cases of NPT. The laparoscopic evaluation of abdominal testes can provide indications for the most suitable surgical technique; moreover, in 23% of patients, it makes abdominal exploration unnecessary. The value of laparoscopy is even greater if the anatomical aspect of the internal ring and spermatic cord structures is carefully evaluated.
