Neonatal inguinoscrotal lesion produced by plastic umbilical clamp

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Editorial correspondence is subject to critical review and to current editorial policy in respect to publication in part or in full. Preference is given to letters related to articles published in THE JOURNAL, but letters on topics of current interest may be accepted if space is available. Letters are restricted to 300 words or less, and 3 supporting references.

Neonatal inguinoscrotal lesion produced by plastic umbilical clamp To the Editor: In THE JOURNAL in 1978, two cases of "neonatal inguinoscrotal lesion produced by plastic umbilical clamp" were described? We subsequently saw a 7-day-old boy in the Pediatric Department of the University of Naples, because o f a hematoma o f the right inguinoscrotal region with swollen testicle which had not been evident at birth. A testicular torsion was considered but the presence of an inguinal hematoma suggested the possibility of a clamp lesion. In the cases of inguinoscrotal hematoma reported in the article, in which there was no swollen testicle, it was recommended that one should try to avoid confusion with a testicular torsion and a useless operation.

In our patient, because of the presence of testicular swelling, we felt surgical exploration of the inguinoscrotal region necessary and we found hemorrhagic infiltration of the cord and the right hemiscrotal region with a vaginal hematoma (Figure) which was emptied; the testicle was undamaged. Since the lesion was not due to testicular torsion or to coagulation problem or delivery trauma, we believe that it was caused by the same mechanism described in the reported cases. Our observation suggests extension of the process, probably determined by a more distal application of the clamp and by greater or more prolonged compression in the inguinal region, causing more hemorrhagic infiltration. B. Cigliano Department of Pediatric Surgery R. Paludetto Neonatal Unit 11 Policlinico- Universita" Via Pansini 5 Naples, ltaly

REFERENCE 1.

Rodriguez-Alarcon J, Vargas LM, and Solaun MR: Neonatal inguinoscrotal lesion produced by plastic umbilical damp, J PEDIATR 93:1024, 1978.

Long-term low-doseprostaglandin E1 administration To the Editor: We were interested to read the report of Pitlick and associates.' Recently seven cyanotic infants have been referred to the

See r e l a t e d article, p. 834.

Figure.

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TheJournalofPEDIATRICS

Department of Pediatrics, Gunma University, School o f Medicine, and were treated by long-term administration of prostaglandin E1 (PgE0 in a low dose which allowed adequate growth. PgE,