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1. Mixed gonadal dysgenesis

Figure 55-1

Mixed gonadal dysgenesis.

This infant with an XY karyotype had a small penis, hypospadias, and a labioscrotal fold at the base of the penis.

A. Sonography confirms the presence of a left testis (T) in the upper aspect of the scrotum. The penis (P) is medial to the testis on this transverse image. There was no identifiable right gonad. B. Examination of the pelvis demonstrates a uterus (arrows) superior to a fluid-filled vagina (V). Laparoscopic exploration demonstrated a right streak gonad.

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2. Urogenital sinus

Figure 55-2

Urogenital sinus.

A-C. Lateral images from genitograms of 3 different infants with ambiguous genitalia show common genitourinary channels of varying lengths.

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3. Female pseudohermaphroditism due to congenital adrenal hyperplasia

Figure 55-3

Female pseudohermaphroditism due to congenital adrenal hyperplasia.

This infant had labial-scrotal fusion, no palpable gonads, and a single genitourinary opening at the base of a slightly enlarged clitoris. A. Contrast injection of the perineal opening demonstrates a short urogenital sinus (arrow) that communicates with a urethra and a vagina (V). B. A longitudinal sonographic image shows a cervix (arrow) projecting into a fluidfilled vagina (V). The uterus (UT) is dorsal to the bladder (B).

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