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Spontaneous hemorrhage of the scrotum in the newborn is an entity very rarely encountered in clinical practice and characterized by scrotal mass and slightly bluish discoloration. We present two cases of spontaneous idiopathic hemorrhage of the scrotum and review the literature. The difficulty in establishing the diagnosis and ruling out testicular torsion is outlined. The importance of ultrasounds in distinguishing between testicular and scrotal acute disease is stressed. Indications for surgery are: the important scrotal hematoma and the patent processus vaginalis.

Cystic dilatation of Cowper's gland ducts (Cowper's syringocele) is uncommon in pediatric age. Cowper's syringocele frequently are asymptomatic, sometimes may cause dysuria, pollakiuria and obstructive voiding symptoms. We report ten children with syringocele. Five were observed for recurrent urinary infections, three for obstructive voiding symptoms and two for post-traumatic hematuria and for urinary incontinence. Only three patients with obstructive urethral symptoms were surgically treated. In our opinion careful clinical, radiologic and endoscopic evaluation is necessary in such cases so that unnecessary surgery can be avoided.

Between 1973 and 1993 7 perineal testis are observed and operated on in our surgical department. The perineal testis is a rare ectopic testis probably caused by some mechanical obstacles in the entrance of the testis in the scrotum. A diagnosis is easy if also the less frequent localizations of testicular ectopia are palpated. Surgery must be precociously performed or, in case of late discovery, upon diagnosis effected because the perineal testis is particularly subject to traumathisms. Orchiopexy is easy to perform, the results are good and, if promptly treated, this form of ectopia has an excellent prognosis of fertility.

Indication for surgical treatment and its results are reported in 17 consecutive cases of diaphragmatic eventration in pediatric age. Fourteen of the patients are males and 3 are females. Eleven of them had a right eventration 6 had a left eventration. Three of the patients were new-born, 13 were aged from 6 months to 3 years and 1 was aged 6 years. Two patients had gastroesophageal reflux, 1 had right intralobar pulmonary sequestration, and another had inguinal hernia. In 2 of the new-born the eventration was caused by a phrenic nerve palsy (in 1 case resulting from birth trauma, while in the other one resulting from multiple thoracentesis). In this last patient surgical treatment wasn't performed, and restitutio ad integrum was observed in 4 weeks' time. The indication for surgical treatment in 2 new-born patients was persistent polypnoea and dyspnoea unresponsive to medical treatment, in 12 of the patients were relapsing bronchitis and bronchopneumonia. Moreover 1 patient with few symptoms but with important diaphragmatic eventration was operated. In all the patients a diaphragmatic plication with fixing of the diaphragmatic plica to the ribs was performed through a thoracic approach. Neither complication or deaths were noticed. There was an immediate remission of the symptomatology in all the cases examined. No relapse of eventration or restarting of the symptomatology was found during a follow-up for a period of 2 to 8 years.