Continuous Splenogonadal Fusion Diagnosed by Laparoscopy in a Child With a Communicating Hydrocele

Abstract

Splenogonadal fusion is a rare congenital anomaly primarily affecting males, characterized by an abnormal fusion of the spleen and the gonad. There are two primary forms: continuous, in which the normal spleen is directly connected to the gonad via a cord of fibrous or splenic tissue, or a combination of both, and discontinuous, in which ectopic splenic tissue fuses to the gonad without connection to the normal spleen. Continuous splenogonadal fusion is often associated with other congenital defects, such as cryptorchidism, limb anomalies, and micrognathia. Due to its rarity and nonspecific symptoms, splenogonadal fusion is typically diagnosed incidentally during surgery for undescended testis or inguinal hernia. We present a case of a five-year-old boy with a communicating hydrocele who underwent surgical repair. Intraoperative findings during inguinal exploration revealed a fibrous connection to the upper pole of the left testicle, extending into the internal inguinal ring. Diagnostic laparoscopy confirmed continuous splenogonadal fusion, demonstrating splenic tissue and a fibrous cord with islands of splenic tissue extending from the spleen to the internal inguinal ring. A portion of the fibrous cord with splenic nodules was excised and examined pathologically, confirming the diagnosis of splenogonadal fusion. The diagnosis of continuous splenogonadal fusion primarily relies on intraoperative findings during surgery for other conditions. Laparoscopy can be instrumental in diagnosing this rare condition.