Torsion in an Ectopic Testis: A Case Report

Abstract

Torsion in the ectopic testis is a rare condition and very difficult to diagnose clinically. We present one such case with review of literature.

Abdominal wall ectopic testis torsion mimicking a Spigelian hernia in an adult

“…One case reports an indirect hernial sac containing testis and spermatic cord in an adult patient with cryptorchidism 3 while the other reports a 21-year-old patient in whom a testis was identified in the superficial inguinal pouch on ultrasonography of the abdomen, between Scarpa's fascia and the external oblique aponeurosis. 4 Consequently, our case report appears to describe the first case of an ectopic testis between internal and external oblique aponeuroses in an adult. Spigelian-cryptorchidism syndrome has been described in the literature as a congenital syndrome involving the combination of a Spigelian hernia, an absent inguinal hernia and an ipsilateral ectopic testis that is commonly located in the Spigelian hernia, prompting the assessment of cryptorchidism in infants with a Spigelian hernia.…”

A spontaneous acute abdomen revealing testicular torsion of an undescended testicle

“…[1] Testicular torsion is a diagnostic and therapeutic emergency that needs to be managed rapidly for testicular salvage due to the high risk of destruction of spermatogenic and Sertoli cells in 4 h period of ischemia. [2] Torsion of undescended testis is an exceptional condition. It is rarely seen as a differential diagnosis of acute abdominal pain because of the lack of physical assessment of the external genitalia as part of the clinical examination.…”

“…[3] Despite that the undescended testis is more predisposed to torsion, only a few cases were reported in the literature. [2] Its etiopathogenic is still controversial.…”

“…Neural tube defect disorders, cerebral palsy, and genetic disposition are identified risk factors seen in undescended testes. [2], [4] It has been proposed in patients with neuromuscular disorders that abnormal contractions of the cremasteric muscles can cause torsion, or that contractures of the hips prevent descent into the normal scrotum. Moreover, infertility and testicular cancer are the principal complications of untreated cryptorchidism.…”