Part 2 book “Neonatology” has contents: Congestive heart failure, gastrointestinal bleeding, hemolytic diseases of the newborn, intestinal obstruction, intrauterine growth restriction, intrauterine growth restriction, nonimmune hydrops fetalis, respiratory distress, transient skin lesions, and other contents. | 304 Subgaleal Hematoma SUBGALEAL HEMATOMA . LORENZ, MD REVISED BY HELEN M. TOWERS, MD ■ Bleeding beneath epicranial aponeurosis connecting frontal, occip- ital portions of occipito-frontalis muscle ■ Rare history & physical Signs ■ Firm to fluctuant mass extending onto neck, forehead ■ Borders ill defined, may be crepitant ■ Progressively increases from birth ■ May be massive tests ■ Nonspecific ➣ Consider PT/PTT, fibrinogen, D-dimers, platelet count if very large or other bleeding ➣ Skull film for basilar skull fracture w/ hemotympanum, serosanguinous otorrhea, postauricular ecchymosis ■ Specific: head CT scan (rarely indicated) differential diagnosis ■ Caput succedaneum ■ Cephalohematoma management ■ Correction of hypovolemia & coagulopathy as indicated specific therapy None; aspiration contraindicated follow-up None w/o complications complications and prognosis ■ Complications ➣ ➣ ➣ ➣ Hypovolemia Prolonged hyperbilirubinemia Anemia Skull fracture ■ Prognosis: resolves spontaneously in 2–3 wk 305 Testicular Torsion TESTICULAR TORSION TERRY HENSLE, MD GRACE HYUN, MD history & physical ■ ■ ■ ■ Discolored (dark) scrotal mass Asymptomatic, firm to hard gonad Scrotum dusky, swollen No transillumination tests ■ Doppler ultrasound ■ Nuclear scan differential diagnosis ■ ■ ■ ■ Incarcerated hernia Birth trauma (hematoma) Yolk sac tumor Hydrocele management N/A specific therapy ■ Observation unless bilateral (testis rarely salvageable) versus ■ Orchiectomy +/ − contralateral orchiopexy: increasingly common therapeutic approach follow-up ■ +/ − testicular prosthesis ■ If bilateral ➣ Endocrine follow-up for hormone replacement ➣ Psychiatry follow-up complications and prognosis N/A 306 Tetralogy of Fallot (TOF) TETRALOGY OF FALLOT (TOF) KALYANI R. TRIVEDI, MD, AND LEE N. BENSON, MD REVISED BY GANGA KRISHNAMURTHY, MD ■ “Tetralogy” ➣ ➣ ➣ ➣ Large, malaligned ventricular septal defect Overriding aorta Right ventricular hypertrophy Right .
