A 21 years old male attended our OPD with complaints of a left inguino -scrotal swelling. The swelling was reducible and was present since years of age. On initial examination the sac was felt along with the cord structures in the root of the scrotum. Both testes were descended and the external genetalia was normal. He was diagnosed to have left congenital hernia and underwent elective inguinal exploration. The sac was identified, separated from cord structures and opened. An elongated, purplish-red, fleshy band of tissue was found inside the sac, adherent to the upper pole of testis. Further exploration through the internal ring revealed this tissue was found extending towards the left upper quadrant of the abdomen, trans-peritoneally. Some large vessels were seen on the surface of the band. Gross anatomy of testis appears to be normal. A provisional diagnosis of splenogonadal fusion was made. However, as the relative contribution of the vessels from the band to the vascularity of the testis could not be determined and a pre-operative consent for orchidectomy was not available, it was decided to take a biopsy from this tissue. A vascular clamp was made on the band and viability of testis is ascertained. Band in the inguinal canal was sewen at deep ring and at upper pole of testis and the band in between them was taken for biopsy. A diagnostic laparoscopy was done in the same setting via an open umbilical approach. Complete abdominal exploration showed a vascular connective band coming out of the left internal inguinal ring and directed towards the spleen. Macroscopic appearance showed the surgical specimen (4x2 cms) to be parenchymatous, with histopathological examination demonstrating the presence of splenic tissue, including red pulp and sinusoids confirming the diagnosis of left continuous splenogonadal fusion. The postoperative course was uneventful and the patient was discharged two days post operation. DISCUSSIONSpleno-gonadal fusion is a rare congenital malformation in which the spleen is abnormally connected to the gonads or rarely to the mesonephric structures like vas or epididymis.1 More than 150 cases have been described in world literature so far. Putschar & Manion classified splenogonadal fusion into two types, viz. continuous and discontinuous.2 In the continuous variant, the spleen is connected to the gonads by a fibrous cord, a splenic cord or a beaded cord of mixed fibrous and splenic tissue. In ABSTRACT 21 years old male underwent elective inguinal exploration for left congenital hernia. Per-operatively, an elongated, purplish-red, fleshy and beaded band of tissue was found inside the sac, adherent to the upper pole of testis. Biopsy was taken and the wound closed. A diagnostic laparoscopy was done in the same setting to visualize the origin of the band proved it to be from spleen. The histo-pathology of the specimen was reported as normal splenic tissue. The above features are consistent with a diagnosis of spleno -gonadal fusion (SGF) (splenic anomaly).

Idiopathic perforation of rectum in newborns is extremely rare. Etiology of spontaneous neonatal rectal perforation is unknown. We report a case of idiopathic rectal perforation in a neonate who presented with signs of perforative peritonitis. This case is reported because of its rarity

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