Common surgical problems in children - part 2 Flashcards Preview

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1

What is the clinical presentation of idiopathic scrotal oedema ?

  • Unilateral (90% of the time) or bilateral erythema seen on the scrotum
  • Sometimes the erythema is seen to spread to the perineum or inguinal region 
  • Swelling of scrotum 

2

What is phimosis ?

It is the inability of the foreskin to be retracted behind the glans penis in uncircumcsied males 

3

At what age does phimosis become abnormal ?

Above the age of 4 as it is normal before then 

4

What is the management plan for phimosis ?

Usually resolves on its own but if it shows no signs of resolving then:

  • First line - give steroid cream e.g. bethamethosone 
  • Second line - surgery if this doesn't work 

5

What is paraphimosis ?

A urologic emergency in which the retracted foreskin of an uncircumcised male cannot be returned to its normal anatomic position

6

What are some of the complications of paraphimosis ?

Gangrene and amputation of the glans penis 

7

What is the management of paraphimosis ?

  • Squeeze the fluid out of the foreskin and pull it back over the glans penis, may need to give pain relief 
  • If this doesn't work may need to make a slit in the foreskin to relieve pressure 

8

What is hypospadias ?

Combination of 3 problems:

  • The hole through which urine passes (meatus) is not at the tip of the penis
  • The foreskin is gathered at the back of the penis with none at the front 
  • The penis may be bent when stiff. 

9

How is hypospadias treated ?

With surgery 

10

What is a hydrocele ?

The accumulation of serous fluid in a body sac.

11

What are the signs/symptoms of a hydrocele testis ?

Swelling of the teste 

Can be transilluminated with light 

You can feel above the swelling 

12

What is one of the ways you can differentiate a hydrocele testis from a hernia ?

You can feel above the swelling 

13

How do undescended testicles commonly present ?

Commonly present with emptiness in the scrotum and often the undescended testicle(s) are palpated in the inguinal canal 

14

What is the management of undecended testicles ?

If not dedescended by first 6 months of life then often a surgical procedure called orchidopexy to move them down