Abstract
Most undescended testicles are asymptomatic and diagnosed in the first years of life. In some rare cases the diagnosis is established during childhood due to sudden torsion of the spermatic cord. Additionally, testicular torsion is a well-known urologic emergency that needs to be diagnosed and treated rapidly for the salvage of testis. We are here with reporting a case of torsion of an undescended testis with unusual clinical presentation, as acute abdomen, and its diagnostic dilemma and management.
Highlights
Undescended testis is one of the common conditions in children requiring surgical correction
Unusual presentations have been reported with torsion of intra-abdominal testis with incidence of 31%; as they might present like features of acute appendicitis or bowel obstruction; leading to diagnostic and management dilemma [5]
Radford et al [6] reported a case of inguinal undescended testis which presented as acute appendicitis and concluded that an intra-abdominal testis can lead to acute lifethreatening complications and should be considered in any patient with acute abdominal symptoms who has an “absent” testis
Summary
Undescended testis is one of the common conditions in children requiring surgical correction. Common presentations of testicular torsion are pain, swelling and redness; which requires urgent intervention for salvaging the testis. We are here with reporting a case of torsion of an undescended testis with unusual clinical presentation, as acute abdomen, and its diagnostic dilemma and management. Baby was listless, drowsy and had severe dehydration His pulse rate was -156/min, BP-50/30mmhg, SpO290% on room air. On examination he had distended abdomen with dilated bowel loops, had diffuse tenderness and absent bowel sounds. Phallus was normal with left descended testis in the scrotum His blood urea was 140/mg and serum creatinine of 2.2mg/dl without much electrolyte and blood gas abnormalities at admission. In view of suspected testicular torsion, right groin exploration was done, which revealed gangrenous testis [Fig. 2], right
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