A case of spontaneous priapism in a ten year old child with acuta lymphoblastic leukaemia is presented. Emergent management options like drainage, sympathomimetic agents, and medical treatment to reduce circulating white cell counts and shunt surgery are discussed.

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Penile necrosis due to monopolar cauterization during circumcision is a rare complication and may cause organ loss. When monopolar cauterization applied on an end-organ, current flows through the organ and, causes disruption of blood flow and oxidative stress. Penile injury may include skin, glans and cavernous bodies. Injury can be limited with the help of medical treatment and hyperbaric oxygen treatment, but eventually the need for reconstruction arises. Some case reports of application of feminizing genitoplasty after total organ loss are present on the literature. However, lengthening of penis via dissection of cavernous bodies and application of skin graft seems more appropriate as a method of reconstruction. At this case report, three-year old male who had penile necrosis after having circumcised at another center will be discussed under the light of current literature. As soon as the patient was hospitalized, medical treatment and hyperbaric oxygen treatment started. However circulation of the necrotic tissue didn’t improve and necrotic part of the penile skin, glans and cavernous bodies were debrided. After the debridement, two centimeters of cavernous body remained. Once tissues recovered, as a second operation, cavernous bodies were dissected through pubic arms and skin graft was applied. As a result, five centimeters of penile body was achieved. Post-operatively no problem was encountered and patient was discharged 23 days after circumcision.

A case of spontaneous priapism in a ten year old child with acuta lymphoblastic leukaemia is presented. Emergent management options like drainage, sympathomimetic agents, and medical treatment to reduce circulating white cell counts and shunt surgery are discussed.

Congenital Anterior Urethral Diverticulum (CAUD) is defined as a cystic dilatation of the anterior urethra and is one of the rare causes of bladder outlet obstruction. The association of this urethral anomaly with the posterior urethral valve is extremely rare. In this case, we found the association of congenital urethral diverticulum and posterior urethral valve and we aimed to present it.

Neonatal adrenal hemorrhages (NAH) may be encountered in cases of perinatal asphyxia. The differentiation of malignant lesions and bleeding in the adrenal gland detected in the neonatal period is very important for treatment and prognosis. Ultrasonography (US) is the first preferred imaging method in NAH because it is non-invasive and easy to apply. Vascularization is not detected in hematomas in Doppler US examination. However, conventional Doppler imaging techniques (CDIT) may not adequately show the blood flow (BF) of the lesions. Super micro-vascular imaging (SMI) is a new vascularization imaging technique that eliminates motion artifacts, provides detailed information about very slow blood flow, and allows imaging of microvascular structures. SMI can be operated in 2 modes: color SMI (cSMI) and monochrome SMI (mSMI). The cSMI mode simultaneously displays a conventional grayscale US with color-coded Doppler signals. The monochrome SMI mode improves the visibility of vascular structures by eliminating background signals and focusing only on vasculature signals. In this case report, we aimed to present a case of NAH detected by SMI in the neonatal period and we wanted to emphasize the usefulness of SMI.

Proximal Sars-Cov-2 pandemic had radically changed the way surgeons work in many departments, forcing to reserve surgical treatment only for emergency and oncologic cases. We report a case of a ten months-old girl with right-sided Wilms tumor and a previous diagnosis of Sars-Cov-2 infection, who underwent open right nephrectomy. Surgery was planned after negativization of five nasopharyngeal tests, despite the simultaneous positivity of two rectal swabs. The procedure was performed safely with appropriate personal protective equipment (PPE). To better investigate viral excretion, the anesthetist repeated nasopharyngeal swab under general anesthesia, which resulted positive. At the same time, two peritoneal swabs were collected and showed the absence of the virus in the peritoneal fluid. This case highlights the importance of combining swabs from various sources to increase sensibility of the test. The value of nasopharyngeal swab under general anesthesia should be reinforced as it can result positive even after many negative tests. Very little is known about\ntransmission of the virus through the peritoneum as both presence and absence of Sars-Cov-2 have been reported in the peritoneal fluid. Next literature will clarify which particular conditions determine viral penetration in this anatomical district.

We reported a case of donkey bite to the external genitalia of a 10 years old child. We had performed delayed reconstruction of the penis following adequate saline washing and wound debridement; under antibiotic coverage. Previous studies have shown that delayed repair together with strict wound management resulted in satisfactory outcomes in most victims of such animal bites.

Absence of any orifice in perineum, presence of smooth perineum, and absence external genitalia are characteristic of cloacal dysgenesis sequence (CDS). Newborn of 40w gestational age, born to mother with oligohydramnios, had very low APGAR scores, and was put on ventilator. Child had dysmorphic facies, short neck, compressed chest, no urinary bladder swelling, absence of any perineal orifice, a raised fold of skin at the site of phallus and bilateral talipes calcaneovalgus. Esophageal atresia (EA) was diagnosed clinically and radiographically. Pulmonary hypoplasia, distal tracheoesophageal fistula (TOF), thin, flat and broad cervical vertebrae with spina bifida, partial sacral agenesis and cardiac anomalies were demonstrated by radiographs and echocardiography respectively. Child progressively more desaturated on ventilator and died at 16h after birth before detailed assessment including sex could be done. CDS results from failure of urorectal septum to fuse with cloacal membrane at 7th week of intrauterine life. It can occur in male and female. CDS is lethal resultant from associated severe pulmonary hypoplasia and renal insufficiency. Very rarely such child is born alive as in our case. Association of CDS with EA+TOF is extremely rare. In view of 5 long-term survival reports of CDS, prenatal diagnosis is warranted and treatment should be initiated.

Splenogonadal fusion is a rare cause of scrotal swelling. We present a case of a 9-year-old boy with a left testicular mass and phocomelia who was found to have splenogonadal fusion upon scrotal exploration. We discuss the etiology, pathophysiology and management of splenogonadal fusion.