The most serious causes of acute scrotal swelling are testicular torsion and incarcerated inguinal hernia, both of which necessitate immediate surgical correction. Consequently, a prompt, careful approach to a painful or inflamed scrotum is essential. The differential diagnosis of scrotal…
Hematuria is a common issue faced by primary physicians who care for children. While it can cause great anxiety in the patient and family when it presents as gross hematuria, rarely does hematuria alone herald a serious illness during childhood.…
Proteinuria can be detected by various means, and the most common is the dipstick test, a calorimetric assay that spots only albumin and not low-molecular-weight proteins. In addition, false-positive dipstick assessment can be seen with highly concentrated urine, alkaline urine,…
Dysuria is defined as painful urination and can be related to uncomfortable contraction of the muscles of the bladder or when urine comes into contact with the inflamed genitourinary mucosa. The differential diagnoses for a patient presenting with dysuria are…
An abdominal mass or abdominal fullness in a child usually becomes apparent when it enlarges enough to be visualized during bathing or palpable on physical examination. Masses may arise from intraperitoneal, retroperitoneal, or abdominal wall locations and emanate from both…
Constipation is defined symptomatically as the infrequent passage of hard stools, straining while passing a stool, or pain associated with the passage of a hard stool. The range of normal defecation patterns in children is widely variable, though in general,…
Jaundice, the yellow discoloration of skin and sclerae, results when the serum level of bilirubin, a pigmented compound, is elevated. Jaundice is not evident until the total serum bilirubin is at least 2–2.5 mg/dL in children out of the neonatal…
Hepatomegaly can occur as a feature of primary liver disease or as a result of systemic disorders such as congenital anomalies, inborn errors of metabolism, and perinatal or postnatal infections ( Tables 17.1 and 17.2 ). Common symptoms of hepatic dysfunction,…
Gastrointestinal (GI) bleeding in children can range from small amounts of blood in the stool, associated with milk protein allergy or anal fissure, to life-threatening hemorrhage, associated with portal hypertension or peptic ulcer disease. Severe bleeding is a true medical…
Definitions Vomiting/emesis is a protective reflex in response to a variety of stimuli that results in forceful ejection of stomach contents. The emetic reflex is complex and composed of three sequential events. Initially there is a prodromal phase characterized by…