Special Considerations

8.1 Introduction 73

8.2 Adrenal 73

8.2.1 CAH and Intersex 73

8.2.2 Adrenal Hemorrhage 75

8.3 Kidney 75

8.3.1 Anomalies and Masses 75

8.3.2 Cystic Renal Lesions 76

8.3.3 Solid Renal and Juxtarenal Lesions 78

8.3.4 Pyelonephritis and Pyonephrosis 80

8.3.5 Trauma 82

8.3.6 Calculi 83

8.4 Bladder 84

8.4.1 Exstrophy 84

8.4.2 Bladder Trauma 86

8.4.3 Bladder Rupture Postaugmentation 87

8.4.4 Urinary Retention 87

8.5 External Genitalia 89

8.5.1 Penis 89

8.5.1.1 Circumcision Injuries 89

8.5.1.2 Paraphimosis and Phimosis 90

8.5.1.3 Urethral Trauma 91

8.5.2 Scrotum 93

8.5.2.1 The Acute Scrotum 93

8.5.2.2 Testicular Torsion 93

8.5.2.3 Neonatal Torsion 93

8.5.2.4 Pediatric Torsion 94

8.5.2.5 Epididymitis 94

8.5.2.6 Idiopathic Scrotal Edema 95

8.5.2.7 Henoch-Schönlein Purpura 96

8.5.2.8 Scrotal Masses 96

8.5.2.9 Testis Tumors 96

References 97

fore cover common emergent and urgent pediatric urologie consultations encountered from birth through childhood. Prenatal diagnoses and their respective management options (such as fetal obstructive uropa-thy) will not be considered, as they are beyond the scope of this chapter and do not necessarily reflect the typical urologic conditions encountered in the emergency department. The chapter will progress via an anatomical top-down approach, emphasizing various conditions from adrenal disorders to scrotal and testic-ular pathology.

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