morphine and Hernia--Inguinal

Durmuş G, Boybeyi-Türer Ö, Gharibzadeh-Hizal M, Ekinci S, Kiper N. Meconium periorchitis: An incidentally diagnosed rare entity during inguinal herniorraphy. Turk J Pediatr 2018; 60: 612-614. Meconium periorchitis (MPO) is a rare disorder caused by meconium peritonitis with the leakage of meconium into the scrotal sac through the patent processus vaginalis. MPO may be rarely detected during inguinal hernia repair. The association of MPO with cystic fibrosis is rarely seen. We present a male infant with the complaint of left groin swelling, compatible with reducible inguinal hernia. An herniotomy was carried out and the greenish nodules with calcifications were detected. Histopathological examination was compatible with MPO. Two months later the patient was diagnosed with atypical cystic fibrosis. Clinicians should be aware of MPO presentations and its appearance on the hernia sac to prevent unnecessary orchiectomy.

Topics: Cystic Fibrosis; Groin; Hernia, Inguinal; Herniorrhaphy; Humans; Incidental Findings; Infant; Infant, Newborn; Male; Meconium; Orchitis; Scrotum

A case of meconium periorchitis detected by fetal MRI and misdiagnosed during pregnancy as inguinoscrotal hernia is reported for the first time. A full-term black boy presented at birth with an asymptomatic, 'stony-hard', scrotal mass suggestive of an in utero testicular torsion or testicular/paratesticular tumor. Early surgical treatment resulted in the removal of paratesticular yellowish amorphous material. Histology was consistent with the diagnosis of meconium periorchitis, a rare and benign condition resulting from healed intrauterine bowel perforation.

Topics: Cysts; Diagnosis, Differential; Female; Hernia, Inguinal; Humans; Infant, Newborn; Intestinal Perforation; Magnetic Resonance Imaging; Male; Meconium; Orchitis; Pregnancy; Prenatal Diagnosis; Scrotum

The usual manifestations of meconium peritonitis confined to the inguinoscrotal region are soft hydroceles, hard nodules in the scrotum, and, occasionally, calcified nodules in the wall of a hernia sac, with or without calcification on abdominal X-ray. Inguinal hernia is an extremely rare manifestation of healed meconium peritonitis. An unusual presentation of meconium peritonitis encountered during hernia repair is described herein to alert the pediatric surgeon of this possibility to avoid unnecessary abdominal exploration.

Topics: Hernia, Inguinal; Humans; Infant; Male; Meconium; Peritonitis

The authors report on a newborn baby with congenital hydrocele in whom pneumoscrotum developed. Air and meconium were found over the hernia sac, owing to ileal atresia with perforation. Gas in the scrotum usually is inside herniated bowel, but it can be the first sign of pneumoperitoneum.

Topics: Air; Emphysema; Genital Diseases, Male; Hernia, Inguinal; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Male; Meconium; Scrotum; Testicular Hydrocele

Topics: Abdomen; Calcinosis; Female; Foreign Bodies; Hernia, Inguinal; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Physical Examination; Treatment Outcome; Ultrasonography; Ureter; Vulva

Topics: Adult; Calcinosis; Female; Fetal Diseases; Hernia, Inguinal; Humans; Meconium; Peritoneal Diseases; Peritonitis; Pregnancy; Radiography; Ultrasonography

Topics: Calcinosis; Granuloma; Hernia, Inguinal; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Scrotum

Perforation of the bowel wall in utero, with meconium gaining access to the tunica vaginalis, results in meconium periorchitis. The clinical and pathologic features in four infants were studied; the findings were compared with those in the 20 cases reported in the literature. In the majority of cases, the intestinal perforation had apparently healed before birth, and the scrotal mass became increasingly obvious following birth. Cystic fibrosis was documented in only one case. A yellowish green paratesticular mass with multifocal dystrophic calcification was the principal gross finding. Lobules of fibromyxoid tissue containing the calcifications were separated by bands of connective tissue. A granulomatous reaction per se was not prominent in the four cases of the present study, although some authors have characterized the process as meconium granuloma. Before orchiectomy is performed in an infant with a scrotal mass, the possibility of meconium periorchitis should be considered.

Topics: Calcinosis; Hernia, Inguinal; Humans; Infant; Infant, Newborn; Male; Meconium; Orchiectomy; Orchitis; Scrotum; Testicular Hydrocele; Testis

In recent years patients with cystic fibrosis (CF) have experienced longterm survival and have demonstrated a number of intra-abdominal complications. This report evaluates the intra-abdominal complications seen in 69 of 189 children with cystic fibrosis from 1972 to 1983. Forty-one patients were boys and twenty-eight girls. Complications occurred in 36 neonates, with meconium ileus (MI) noted in 33 and giant cystic meconium peritonitis (GCMP) in 3. Meconium ileus equivalent occurred in seven older children presenting with bowel obstruction. In addition, rectal prolapse occurred in 12, inguinal hernia in 10, intussusception in 3, cholelithiasis in 3, GE reflux in 4, stress ulcer in 1 and appendicitis in 1. Three infants with GCMP survived resection and enterostomy. Infants with MI were divided into simple (15) or complicated (18) cases. Nonoperative therapy using gastrografin enema was successful in three of eight with simple MI. Operative enterotomy and irrigation was successful in three cases while resection and enterostomy was done in nine. MI was complicated by atresia, volvulus and/or perforation in 18 cases requiring resection and anastomosis or enterostomy. Survival for MI was 86% compared to 36% in 25 MI patients treated in the previous two decades. Meconium ileus equivalent was successfully managed using gastrografin enema in five of seven children. Only 3 of 12 children with rectal prolapse required repair. Two cases of intussusception were reduced while one required resection. Three of 10 children had hernia recurrence due to chronic pulmonary problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Abdomen; Adolescent; Child; Child, Preschool; Cystic Fibrosis; Female; Hernia, Inguinal; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Intussusception; Male; Meconium; Peritonitis; Rectal Prolapse

Topics: Duodenum; Emergencies; Esophageal Atresia; Female; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernia, Inguinal; Hernia, Umbilical; Hernia, Ventral; Hernias, Diaphragmatic, Congenital; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Jejunum; Meconium; Pneumothorax; Pregnancy; Pyloric Stenosis; Renal Veins; Rupture; Stomach Diseases; Thrombophlebitis