Consultant for Pediatricians Vol 7 No 12

This baby was born at term via spontaneous vaginal delivery. A large left-sided inguinal hernia that completely filled the scrotum was obvious at birth (A). An ultrasonogram confirmed a complete bowel-containing inguinal-scrotal hernia. No hernia was present on the right side. Both testes were descended. The scrotum is shown after the hernia was reduced by manipulation (B).

The parents of this 8-year-old girl have brought her for evaluation of areas of loss of pigment on her face. They are worried that these might represent the beginnings of vitiligo.

A previously healthy 15-year-old girl presents with right-sided chest pain that began a few hours earlier during Spanish class. The pain is nonradiating; it is alleviated by leaning forward and exacerbated by sitting still. Shortly after its onset, the patient had taken acetaminophen, which provided temporary relief. However, when she returned home from school, the pain resumed. She denies fever, shortness of breath, nausea, vomiting, and cough.

Four-month-old Hispanic boy brought for evaluation because of hypopigmented patches on his skin and a history of seizures. Infant was the product of an uncomplicated pregnancy; born at 40 weeks' gestation to a 16-year-old gravida 1, para 1 mother who received appropriate prenatal care. At birth, he had multiple hypopigmented patches on his face, torso, and extremities. At age 2 months, he was hospitalized for new-onset seizures.