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Abstract

We define as preterm any newborn born before 37 weeks of gestation. The incidence of inguinal hernia is 1–4.4% among full term neonates and older children. In preterm newborns it is significantly more often, with an incidence that raises up to 30%. In this comprehensive review of the literature we provide evidence-based answers in various questions concerning the optimal treatment of inguinal hernias in preterm neonates. Such questions include the proper time of intervention, the choice of optimal anesthesia, the necessity for contralateral investigation in case of an ipsilateral hernia, the prevention of post-operative apnea and the choice between classic and laparoscopic surgical techniques.
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Bibliography

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Authors and Affiliations

Ioannis Patoulias
1
Ioanna Gkalonaki
1
ORCID: ORCID
Dimitrios Patoulias
2

  1. First Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital “G Gennimatas”, Thessaloniki, Greece
  2. First Department of Internal Medicine, General Hospital “Hippokration”, Thessaloniki, Greece
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Abstract

The main target during management of a male pediatric patient with clinical signs of acute scrotum is the timely diagnosis, in order not to jeopardize the viability of the affected testicle. Thorough evaluation of the patient’s medical history, symptomatology, clinical and ultrasonographic findings, con-stitutes the basis of the diagnostic procedure. After comprehensive research of the relevant literature, we highlight the remaining difficulties in the evaluation of the clinical and ultrasonographic findings for the accurate diagnosis of the acute scrotum. In conclusion, it is worth emphasizing on the following: a. the most common diseases that come under the diagnosis of the acute scrotum may present with similar symptoms, b. in neglected cases the diagnostic approach becomes more difficult, constituting the evalua-tion of the pathognomonic clinical signs challenging, and c. inability to exclude the diagnosis of spermatic cord torsion should be an indication for the surgical exploration of the affected hemiscrotum.
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Authors and Affiliations

Ioanna Gkalonaki
1
ORCID: ORCID
Ioannis Patoulias
1
Michail Anastasakis
1
Christina Panteli
1
Dimitrios Patoulias
2

  1. First Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital “G. Gennimatas”, Thessaloniki, Greece
  2. First Department of Internal Medicine, General Hospital “Hippokration”, Thessaloniki, Greece
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Abstract

The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the normal regression procedure, the urachus remains as the median umbilical ligament.
Urachal remnants are present in 1.03% of paediatric patients while in 92.5% of cases represent incidental findings. Urachal anomalies are classified in four types as patent urachus (50–52%), urachal sinus (15%), urachal cyst (30%) and urachal diverticulum (3–5%). Ultrasound scan is the most commonly performed diagnostic imaging study.
In case of symptomatic urachal remnants, surgical excision is indicated. Asymptomatic urachal remnants that are diagnosed at the neonatal period or early infancy should be watched up to 6 months of age, as they are likely to resolve. In persistent or symptomatic urachal remnants there is a risk of inflammation or even malignancy development, therefore we believe that there is indication for preventive surgical excision that may be performed either open or laparoscopically or by robot-assisted laparoscopy.
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Authors and Affiliations

Ioanna Gkalonaki
1
ORCID: ORCID
Ioannis Patoulias
1
Michail Anastasakis
1
Christina Panteli
1
Dimitrios Patoulias
2

  1. First Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital “G. Gennimatas”, Thessaloniki, Greece
  2. First Department of Internal Medicine, General Hospital “Hippokration”, Thessaloniki, Greece

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