Splenogonadal Fusion Presenting as Acute Torsion of Testis

Abstract

Splenogonadal fusion (SGF) is a rare congenital anomaly noticed mainly in boys. The usual presentation is of testicular swelling and is managed most of the time with avoidable orchidectomy. Here we report a case of SGF in a one year old boy presenting with tender swelling on the left inguinal region and empty left scrotum. With the suspicion of torsion left inguinal testis, left inguinal exploration with laparoscopy was done as emergency procedure. It revealed left inguinal testis adherent to a torted segment of continuous type of spleenunculi which extended up to the spleen intra abdominally. Child underwent excision of this splenunculi with left orchidopexy. Pathology of the specimen was reported as torsion of splenunculi. Most of the SGF are incidental finding that are noticed during elective herniotomy or orchidopexy. But there are few cases reported in literature where SGF can present as an acute condition mimicking torsion of testis. A testis preserving excision of splenunculi should be done in these patients as there is usually a clear demarcating plane between them.