Andrew L. Wong, MD

September 14, 2005

This condition is characterized by a localized narrowing of the jejunum without a disruption of continuity or defect in the mesentery. At the stenotic site, there is often a short, narrow segment with a minute lumen where the muscularis is irregular and the submucosa is thickened. The resultant intestinal obstruction is incomplete.

September 14, 2005

Congenital adrenal hyperplasia is an autosomal recessive disorder. Deficiency of 21-hydroxylase accounts for 95% of all cases.

September 14, 2005

A painful, swollen penis was the presenting complaint of an 11-year-old boy. The swelling erupted 1 to 2 hours before the photograph was taken, when the child had attempted to retract the foreskin.

September 14, 2005

Affected infants present shortly after birth with a large bowel obstruction secondary to transient dysmotility in the descending colon. Although the cause is unknown, immaturity of the colonic myenteric plexuses has been demonstrated in some cases. More than 50% of affected infants are born to mothers with diabetes. Other predisposing factors include hypoglycemia and sepsis.

September 14, 2005

This condition, which accounts for about 30% of cases of intestinal obstruction among neonates, is characterized by the inspissation of thick, tenacious meconium in the bowel. The most common cause is cystic fibrosis; approximately 6% to 20% of infants with cystic fibrosis have meconium ileus. Hyperviscous mucus secreted by abnormal intestinal glands, an abnormal concentrating process in the proximal small intestine, and a deficiency of pancreatic enzymes have been implicated in the pathogenesis. The histologic hallmark is distention of the goblet cells in the intestinal mucosa.

September 14, 2005

A 7-year-old boy presented with two testicles on the left side of the scrotum. The superior one was half the size of the inferior one, which measured 2 × 1 cm. The testicle on the right side measured 2 × 1 cm. Surgical exploration was done, and the atrophic left supernumerary testicle shown in the photo was removed. Biopsy specimens taken from the remaining testicle were normal.

September 14, 2005

Alimentary tract duplications are uncommon. Gastric duplication accounts for only 3.8% of these duplications. The cause is not known, but faulty separation of the endoderm and notochord early in embryonal development is thought to be responsible. The anomaly occurs in twice as many female as male infants.

September 14, 2005

A female infant was born vaginally to a gravida 4, para 1, 24-year-old woman at term. The child's birth weight was 2,800 g; her length was 51 cm. The mother had a history of three spontaneous abortions. The present pregnancy was complicated by threatened abortion at 15 weeks. The mother was given hydroxyprogesterone hexanoate, 500 mg IM weekly for 6 weeks.

September 14, 2005

During the last few weeks of gestation or shortly after birth, the layers of the processus vaginalis normally fuse together and obliterate the entrance to the inguinal canal in the vicinity of the internal inguinal ring. An indirect hernia results from a failure of fusion of the processus vaginalis; the bowel subsequently descends through the inguinal canal.

September 14, 2005

The mother of a 1-month-old infant was concerned because her child's umbilicus looked abnormal. The condition was diagnosed as umbilicus cutis.