Congenital Anomalies :

• Haemangioma
  
  
• Cystic hygroma
  
  
• Branchial sinus, fistula
  
  
• Thyroglossal cyst, fistula
  
  
• Hypospadias
  

• Posterior urethral valve
  
  
• Hydronephrosis
  
  
• Congenital hernia, hydrocele
  
  
• Undescended testes

 

 

 

Know The Types Of Inguinoscrotal Swelling In Children!

 

Inguino-scrotal and Inguino-labial swellings are common in children during infancy. A common cause of an Inguino-scrotal swelling in children is the presence of a patent processus vaginalis. It presents in the form of an inguinal hernia or hydrocele. Male infants are often affected 3 to 6 times more than the female ones. Processus vaginalis is the outpouching of peritoneum that extends through the inguinal canal. It is first seen during the 3rd month of intrauterine life. It follows the gubernaculum and testes through the inguinal canal and reaches the scrotum by the 7th month of gestation. 

 

Differential diagnosis of inguino-scrotal swelling in children: 

1. Inguinal hernia and hydrocele 
2. Torsion testes, epididymorchitis 
3. Undescended testes 
4. Varicocele 
5. Enlarged inguinal lymph node 
6. Abscess or lipoma 

Normally after the testicular descent, the portion of processus vaginalis surrounding the testis becomes tunica vaginalis. The processus vaginalis gets obliterated, eliminating the communication between peritoneal cavity and scrotum. A patent processus vaginalis is seen up to 20% in adulthood. 

 

Hernia and Hydrocele: The testicles or ovaries form in the abdomen near the kidneys, between 3 to 4 months of fetal development. Further, they gradually move down into the lower part of the abdomen as the fetus continues to develop. On descending downwards, small part of the peritoneum (a layer of tissue lining the abdomen from inside) that attaches to the testicle is drawn with it into the scrotum. This forms a pouch or sac. A similar process occurs in females as the round ligament of the uterus descends into the groin at the labia. The sac formed is processus vaginalis. Any connection between the abdominal cavity and the scrotum or groin is eliminated. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia. Stretching of processus vaginalis creates the inguinal sac that allows organs an extension from abdomen and entry into the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele. Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally). 

 

Epididymorchitis: Epididymitis is the pain and swelling of the tube that attaches to each testicle called as the epididymis. Orchitis is pain and swelling of the testicle. Since epididymis and testis lie next to each other, differentiation of the inflamed part is difficult. Hence, the term epididymo-orchitis is often used. Infection with bacteria often causes these problems. Other causes are infections from surgery or from a catheter that drains urine. The mumps virus also can cause orchitis. Analgesics or anti-inflammatory medicines can reduce the pain. Antibiotics are used if the problem is caused by bacteria. 

 

Torsion testis: It is a painful condition that occurs in the boys. It is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). A decreased blood flow to the testes is caused by torsion of the testes. This torsion essentially strangles them of oxygen and nutrients. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Urgent surgical procedure is undertaken if testicular torsion is confirmed in a child. The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset.

 

 

Congenial Birth Defects In Children - Know How They Can Be Managed!

 

Congenial Birth Defects In Children - Know How They Can Be Managed! Congenital birth defects include: 

 

	Hypospadias: The opening of the urethra is located on the underside of the penis instead of the tip.  Anorectal Malformations: The anus (which is the opening in your bottom through which stool passes through) and the rectum (which is the part of bowel immediately above the anus) have not developed properly. This occurs when the child is in the womb.

Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of the glans. The meatus may be located anywhere along the shaft of the penis from the glans to the perineum. 

 

Hypospadias is classified based on the position of urethral opening i.e. glanular, coronal, penile, penoscrotal and scrotal. Here the urine is deviated downwards towards the legs as the penis is bent downwards. Because of downward curvature of penis, sexual activity becomes difficult. From 6 months onwards hypospadias can be corrected by operation i.e. urethroplasty, where the opening of urethra is brought to the tip of the penis and the penis is straightened. 

 

Anorectal Malformation : Here either there is no anal opening or it opens in a wrong place i.e. in urinary passage or birth canal in girls. It may be high anomaly or low anomaly. The immediate treatment is to make a stoma on the surface of abdomen and then do definitive pull through operation i.e. anorectoplasty when the baby is around 8 to 12 months old.

 

 

 

Consult Paediatric Surgeon If Your Child Has :

 

Inguino-scrotal :

 

Inguino-scrotal and Inguino-labial swellings are common in children during infancy. A common cause of an Inguino-scrotal swelling in children is the presence of a patent processus vaginalis. It presents in the form of an inguinal hernia or hydrocele. Male infants are often affected 3 to 6 times more than the female ones. Processus vaginalis is the outpouching of peritoneum that extends through the inguinal canal. It is first seen during the 3rd month of intrauterine life. It follows the gubernaculum and testes through the inguinal canal and reaches the scrotum by the 7th month of gestation.

Differential diagnosis of inguino-scrotal swelling in children:

 

	Inguinal hernia and hydrocele Torsion testes, epididymorchitis Undescended testes Varicocele Enlarged inguinal lymph node Abscess or lipoma

 

Normally after the testicular descent, the portion of processus vaginalis surrounding the testis becomes tunica vaginalis. The processus vaginalis gets obliterated, eliminating the communication between peritoneal cavity and scrotum.  A patent processus vaginalis is seen up to 20% in adulthood.

Hernia and Hydrocele: The testicles or ovaries form in the abdomen near the kidneys, between 3 to 4 months of fetal development. Further, they gradually move down into the lower part of the abdomen as the fetus continues to develop. On descending downwards, small part of the peritoneum (a layer of tissue lining the abdomen from inside) that attaches to the testicle is drawn with it into the scrotum. This forms a pouch or sac.

A similar process occurs in females as the round ligament of the uterus descends into the groin at the labia. The sac formed is processus vaginalis. Any connection between the abdominal cavity and the scrotum or groin is eliminated. When closure of the processus vaginalis is delayed or incomplete, it may stretch and eventually become a hernia.

Stretching of processus vaginalis creates the inguinal sac that allows organs an extension from abdomen and entry into the sac. If fluid, rather than organs, builds up and remains in the sac, the child has a hydrocele. Approximately 80 percent to 90 percent of inguinal hernias appear in boys. They are more common on the right side, but in about 10 percent of cases, they occur on both sides (bilaterally).

Epididymorchitis: Epididymitis is the pain and swelling of the tube that attaches to each testicle called as the epididymis. Orchitis is pain and swelling of the testicle. Since epididymis and testis lie next to each other, differentiation of the inflamed part is difficult. Hence, the term epididymo-orchitis is often used. Infection with bacteria often causes these problems. Other causes are infections from surgery or from a catheter that drains urine. The mumps virus also can cause orchitis. Analgesics or anti-inflammatory medicines can reduce the pain. Antibiotics are used if the problem is caused by bacteria. 

Torsion testis: It is a painful condition that occurs in the boys. It is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). A decreased blood flow to the testes is caused by torsion of the testes. This torsion essentially strangles them of oxygen and nutrients. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Urgent surgical procedure is undertaken if testicular torsion is confirmed in a child.  The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset.

 

 

Congenial Birth Defects In Children - Know How They Can Be Managed!

 

Congenital birth defects include: 

 

	Hypospadias: The opening of the urethra is located on the underside of the penis instead of the tip. Anorectal Malformations - The anus (which is the opening in your bottom through which stool passes through) and the rectum (which is the part of bowel  immediately above the anus) have not developed properly. This occurs when the child is in the womb.

 

Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of the glans. The meatus may be located anywhere along the shaft of the penis from the glans to the perineum. Hypospadias is classified based on the position of urethral opening i.e. glanular, coronal, penile, penoscrotal and scrotal. Here the urine is deviated downwards towards the legs as the penis is bent downwards. Because of downward curvature of penis, sexual activity becomes difficult. From 6 months onwards hypospadias can be corrected by operation i.e. urethroplasty, where the opening of urethra is brought to the tip of the penis and the penis is straightened.

Anorectal Malformation : Here either there is no anal opening or it opens in a wrong place i.e. in urinary passage or birth canal in girls. It may be high anomaly or low anomaly. The immediate treatment is to make a stoma on the surface of abdomen and then do definitive pull through operation i.e. anorectoplasty when the baby is around 8 to 12 months old.