Recommended referral times Specific guidelines agreed by the New Zealand Society of Paediatric Surgeons provide the most up to date guide as to the appropriate time to refer your patients. Referral Guidlines and Clinical access criteria for Paediatric Surgical Patients
The key guides for more common conditions are described below.
BEWARE If only one testicle is palpable and a hypospadias is present then urgent paediatric surgical assessment is required soon after birth to rule out intersex and to give the parents a surgical plan.
BEWARE For bilateral undescended testes urgent assessment is required just after birth as congenital adrenal huperplasia needs to be ruled out. A surgical opinion is required soon after birth because of issues of intersex and the parents need a surgical plan.
. PAEDIATRIC FEMALE HERNIAS present a number of potentially serious problems.
Firstly beware of the presence of a small mobile FIRM lump in the groin as shown in the illustration. This in a female baby or small girl almost always represents an ovary in a hernia sac and not a lymph gland as many believe. Even if the ovary is reducible the child should be assessed urgently by your paediatric surgical service as we now know that the ovary can be damaged by the hernia in the female just as the testis can be damaged in the male. The surgical repair of female hernias must be done in expert hands as the ovary and tube structures are often adherant to the peritonial lining of the hernia sac and indeed may recieve their blood supply from this. Failure to recognize this can easily lead to damage to these vital structures at the time of surgery.
What features could point to a more serious organic cause? Should any of the following features be present then an early ultrasound can be really helpful.
