Understanding Torsion Testis

Torsion of the testis occurs when the spermatic cord, which provides blood flow to the testicle, twists. This twist can block the blood vessels, leading to ischemia (lack of blood supply) and testicular damage.

Signs and Symptoms of Torsion Testis in Children

Torsion testis presents with specific signs and symptoms that should raise concern for parents and healthcare providers. Common signs and symptoms include:

• Sudden and Severe scrotal or groin Pain: One of the primary symptoms of the torsion testis is sudden and severe pain in the affected testicle. The pain may be accompanied by swelling and tenderness.
• Abdominal Pain: Children with torsion testis may experience abdominal pain, which can sometimes be mistaken for other conditions such as appendicitis.
• Nausea and Vomiting: Due to the intensity of pain, children with torsion testis may experience nausea and vomiting.
• Abnormal Testicular Position: In some cases, the affected testicle may be positioned higher than usual or may be positioned horizontally rather than vertically.

Treatment Options

Prompt diagnosis and treatment are essential to salvage the affected testicle. The following treatment approaches may be considered:

• Manual Detorsion

If the diagnosis is made early and the blood flow is not severely compromised, the testicle can sometimes be manually detorsed. This procedure involves carefully rotating the testicle back into its normal position to restore blood flow. However, manual detorsion is a temporary measure and should be followed by definitive surgical treatment to prevent a recurrence.

• Surgery

Surgical intervention is typically required to permanently fix the testicle and prevent future episodes of torsion.

• Orchidopexy

Orchidopexy is a surgical procedure that involves fixing the testicle in its proper position to prevent torsion. This procedure is often performed on the healthy Testis during the same surgical intervention used to destrose the testicle. This is to prevent torsion of the healthy Testis in the future.

• Removal of Nonviable Testicle

In cases where the blood supply to the testicle has been compromised for an extended period, the testicle may become nonviable. In such cases, surgical removal of the affected testicle may be necessary.

Conclusion

Testicular torsion is an emergency that requires immediate pediatric surgical treatment. It is important to recognize the signs and symptoms of torsion testis in children, such as sudden and severe testicular pain, abdominal pain, nausea, vomiting, and changes in testicular position. Prompt diagnosis and surgical intervention are crucial to restore blood flow to the affected testicle and prevent permanent damage. Timely treatment can help preserve testicular function and ensure the best possible outcome for your child’s urological health Consult Dr. Geeta Kekre for the best treatment.

About Dr. Geeta Kekre

Dr. Geeta Kekre is a Paediatric Surgeon in Pune She is a specialist in pediatric minimal access surgery including robotic surgery as well as reconstructive pediatric urology. After ten years in Mumbai, Dr. Kekre returned to her hometown bringing with her a passion for the surgical care of children and a distinct set of skills in the areas of pediatric minimal access surgery, pediatric endourology, fetal hydronephrosis and antenatal parental counseling, pediatric incontinence, and voiding dysfunction.  Her focus is on tailoring surgical therapy to allow her patients to have as active and fun a childhood as possible while delivering the best achievable medical outcomes.

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What are Kidney and Bladder Stones?

Kidney and bladder stones are hard, mineral-based deposits that can form in the urinary tract. Kidney stones form in the kidneys and can vary in size from a grain of sand to a golf ball. Bladder stones, on the other hand, form in the urinary bladder. Collectively, kidney and bladder stones can be referred to as urinary stones or urinary calculi.

What Causes Kidney and Bladder Stones in Children?

Urinary stones can be caused by a variety of factors such as:

• Dehydration: Children who do not drink enough fluids may be at risk for developing kidney and bladder stones.
• Diet: A diet high in salt, sugar, and processed foods can increase the risk of kidney and bladder stones.
• Genetics: Children with a family history of kidney and bladder stones may be more likely to develop these themselves.

 What symptoms do children with urinary stones have?

Kidney and bladder stones in children may cause one or more of the following symptoms:

• Pain: This is the most common symptom of kidney and bladder stones and may be described as sharp or cramping pain in the lower abdomen, back, or sides.
• Nausea and vomiting: Children with kidney and bladder stones may experience nausea and vomiting, particularly if the stones cause a blockage in the urinary tract.
• Difficulty urinating: Kidney and bladder stones can make it difficult for children to urinate, causing discomfort and pain.

Treatment

If your child is experiencing the symptoms of kidney and bladder stones, it’s important to seek medical attention right away. In many cases, kidney and bladder stones can be treated with a combination of medication and lifestyle changes, such as dietary modifications and increased physical activity. In more severe cases, surgery may be necessary to remove the stones and improve your child’s symptoms.

Conclusion

Kidney and bladder stones can cause significant discomfort and require prompt medical attention.

About Dr. Geeta Kekre

Dr. Geeta Kekre is a Paediatric Surgeon in Pune She is a specialist in pediatric minimal access surgery including robotic surgery as well as reconstructive pediatric urology. After ten years in Mumbai, Dr. Kekre returned to her hometown bringing with her a passion for the surgical care of children and a distinct set of skills in the areas of pediatric minimal access surgery, pediatric endourology, fetal hydronephrosis and antenatal parental counseling, pediatric incontinence, and voiding dysfunction.  Her focus is on tailoring surgical therapy to allow her patients to have as active and fun a childhood as possible while delivering the best achievable medical outcomes.

The post Kidney and Bladder Stones in Children: Symptoms and Causes appeared first on Dr. Geeta Kekre.

What are Gallstones?

Gallstones are small, hard deposits that form in the gallbladder, a small organ located beneath the liver that stores, concentrates, and releases the bile produced by the liver. These stones can vary in size and shape and can be composed of cholesterol, bilirubin, or a combination of both.

What Causes Gallstones in Children?

Gallstones form when the gall bladder’s ability to maintain the flow and concentration of bile is disturbed. Gallstones are essentially a result of gallbladder dysfunction. Some of the causes of this dysfunction are as follows:

1. Preterm babies in the NICU are often at risk for developing gallstones. In this age group, however, the stones are asymptomatic and almost never require treatment.
2. Genetics: Children with a family history of gallstones are at a higher risk of developing them themselves.
3. Obesity: Children who are overweight or obese are more likely to develop gallstones.
4. Sickle cell disease, thalassemia, and hereditary spherocytosis: Children with sickle cell disease and other such hemolytic anemias are at a higher risk of developing gallstones due to the increased breakdown of red blood cells.
5. Dehydration, prolonged fasting, and certain drugs can all result in thick, inspissated bile in the gallbladder in which stones can form.

What are the Symptoms of Gallstones?

Gallstones are often asymptomatic, being discovered by chance on an ultrasound done for other reasons. However, they can sometimes cause a variety of symptoms, including:

• Abdominal pain: This is the most common symptom. The pain is usually “sharp”or “cramping”and localised to the upper part of the abdomen..
• Nausea and vomiting: Children with gallstones may experience nausea and vomiting, particularly after eating a fatty meal ( a meal rich in butter or oil).
• Jaundice: In rare cases, gallstones can block the bile duct and lead to jaundice, a condition that causes yellowing of the skin and eyes.

How are Gallstones in Children Treated?

Currently, the gold standard of treatment for symptomatic gallstones above 3 years of age is cholecystectomy, which is a surgery to remove the dysfunctional gallbladder. Asymptomatic gallstones can be observed without treatment. Medications such as ursodeoxycholic acid have been tried as a stone-dissolving therapy but have failed to show significant results. Symptomatic gallstones must be treated as the risk of complications such as pancreatitis and gallstone ileus are high.

About Dr. Geeta Kekre

Dr. Geeta Kekre is a pediatric surgeon in Pune She is a specialist in pediatric minimal access surgery including robotic surgery as well as reconstructive pediatric urology. After ten years in Mumbai, Dr. Kekre returned to her hometown bringing with her a passion for the surgical care of children and a distinct set of skills in the areas of pediatric minimal access surgery, pediatric endourology, fetal hydronephrosis and antenatal parental counseling, pediatric incontinence, and voiding dysfunction.  Her focus is on tailoring surgical therapy to allow her patients to have as active and fun a childhood as possible while delivering the best achievable medical outcomes.

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Causes 

We still do not know the exact reason why the diaphragmatic hernia occurs. Genetic and environmental factors, both, have been implicated. CDH is also seen to occur with some syndromes. However, in the vast majority of patients, no cause of CDH can be identified.

Symptoms and Diagnosis of Congenital Diaphragmatic Hernia

Today, most cases of congenital diaphragmatic hernia are diagnosed on prenatal ultrasound. Babies born with congenital diaphragmatic hernia struggle to breathe and if not treated appropriately, these babies may not survive more than a few hours after birth. Some babies show symptoms a little later. These symptoms are:

• Difficulty in breathing
• Recurrent pneumonia

Treatment Options 

The treatment of congenital diaphragmatic hernia  involves:

• Medications  and ventilatory support to help the lungs breathe and adapt
• Surgery to close the hole in the diaphragm.

Congenital diaphragmatic hernias can be treated at large hospitals that have all the required infrastructure. It is recommended that the baby is delivered in such a hospital to begin with, so that treatment can be initiated during delivery itself. These babies require to be kept in the Neonatal ICU and usually need ventilator support. Surgery to close the hole in the diaphragm is performed after 48 hours of birth. Depending on the size of the defect in the diaphragm, the surgery may be performed by minimal access techniques.

About Dr. Geeta Kekre

Dr. Geeta Kekre is a Paediatric Surgeon  in Pune She is a specialist in pediatric minimal access surgery including robotic surgery as well as reconstructive pediatric urology. After ten years in Mumbai, Dr. Kekre returned to her hometown bringing with her a passion for the surgical care of children and a distinct set of skills in the areas of pediatric minimal access surgery, pediatric endourology, fetal hydronephrosis and antenatal parental counseling, pediatric incontinence, and voiding dysfunction.  Her focus is on tailoring surgical therapy to allow her patients to have as active and fun a childhood as possible while delivering the best achievable medical outcomes.

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