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Additional Resources Online

e-FIGURE 118.1 Computed tomographic scan with contrast demonstrating left lateral neck
abscess/necrotic lymph nodes from cervical adenitis.


CHAPTER 119 ■ GENITOURINARY
EMERGENCIES
DANA A. WEISS, CYNTHIA R. JACOBSTEIN

GOALS OF EMERGENCY CARE
Children present to the emergency department (ED) with a wide range of urologic
complaints. Some are truly emergent, and some are a source of concern but can
be handled with simple care and reassurance. The ability to triage and treat
urologic emergencies is crucial for the ED physician. There are only a few true
urologic emergencies that must be managed expeditiously: testicular torsion and a
febrile obstructing kidney stone top the list. In addition, conditions such as
paraphimosis and priapism warrant acute attention, while other conditions may
require only assurance and close urologic follow-up.
KEY POINTS
Identification of true urologic emergencies (testicular torsion, febrile
obstructing stone).
Judicial use of imaging in the diagnosis of urgent urologic conditions.
The value of triage: the expedited versus routine follow-up urologic
care.
Complete genitourinary examination is crucial for all abdominal pain
presentations.
RELATED CHAPTERS


Signs and Symptoms
Constipation: Chapter 18

Hematuria: Chapter 36
Inguinal Masses: Chapter 39
Pain: Abdomen: Chapter 53
Pain: Back: Chapter 54
Pain: Dysuria: Chapter 57
Pain: Scrotal: Chapter 61
Urinary Frequency: Chapter 78
Vaginal Bleeding: Chapter 79
Vaginal Discharge: Chapter 80
Medical, Surgical, and Trauma Emergencies
Genitourinary Trauma: Chapter 108
The Children’s Hospital of Philadelphia Clinical Pathways