Presentation
Down syndrome child, presented with an undescended testis, history of swelling in right groin and pain. Duration of symptoms is unknown
Patient Data
Both scrotal sacs are empty.
There is irregular heterogeneous mass seen at the upper part of the right inguinal canal measures 3.2 x 1.6 cm.
It is showing no vascularity on color Doppler. Necrosis is also seen in it. Findings are suggestive of cryptorchidism with testicular torsion followed by infarction. Possibility of neoplastic lesion/ necrotic hernia is less likely.
Small hypoechoic testis seen at the upper part of the left inguinal canal measures 1.8 cm.
Case Discussion
Testicular torsion occurs when a testis torts on the spermatic cord resulting in the cutting off of blood supply. The most common symptom is acute testicular pain and the most common underlying cause, a bell-clapper deformity. The diagnosis is often made clinically but if it is in doubt, an ultrasound is helpful in confirming the diagnosis. Expedient diagnosis and surgical management are critical if the testis is to be salvaged and testicular infarction prevented.
Unfortunately, this patient was lost to follow up and was not willing to undergo surgery.
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