TITLE:
Perinatal testicular torsion—An emergency with grave consequences
AUTHORS:
Dietrich Doll, Josef Erkel, Thomas Erhart, Christian Hönemann
KEYWORDS:
Neonatal; Perinatal; Testicular Torsion; Testicular Necrosis; Orchidopexy; Acute Scrotal Swelling
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.1,
March
25,
2013
ABSTRACT: Introduction: Perinatal testicular torsion is not a frequent, but a
grave finding finding. As only immediate surgical retorsion may save the viability
of the testicle, time is of essence. We report the case of a newborn where
delayed diagnosis led to an unnecessary loss of one testicle. Presentation of
Case: The newborn was presented one day after delivery with a swollen left blue
scrotal pouch. The left testicle was little tender, higher in position and
enlarged. Ultrasound revealed a globular, enlarged testicle left, showing hypodense necrotic areas within. Doppler sound could not detect any perfusion of the spermatic vessels. Scrotal fluid was
present bilaterally. At operation, the testicle was considered unsalvageable,
and left orchiectomy and right orchidopexy were performed. Discussion: In the
new-born, it is more than convenient to perfom ultrasound of both testicles
at the same time, which allows to compare texture and perfusion easily.
Immediate surgical exploration should be performed at any time, even if in diagnostic
doubt. The very most important step though is to professionally recognise and
to react to this pediatric emergency, as time is of paramount essence. Conclusion:
A case of a male newborn with unilateral perinatal testicular torsion is presented,
where typical clinical signs and ultrasound features can be seen. Early
exploration with orchiectomy of the necrotic testicle and orchidopexy of the
healthy side may save the endocrine function and fertility.