Write a 4 pages paper on testicular torsion in neonates. Intravaginal torsion testis has also been reported in neonates (Burge). Most of the cases of .torsion testis detected in the newborn period are believed to occur inutero (2). Torsion testis .occurs due to loose attachments of the tunica to the scrotal wall (4). It is associated with high birth weight (5). Most of the time, it is unilateral and may be associated with undescended testis.
The baby of Gracy Thomas was noticed to have swelling and redness at the right half of the scrotum, 12 hours after birth. The baby was born full-term by normal delivery. The birth weight was 3.5 kg. Antenatal scans were normal. On examination, there was redness and swelling over the right testis. No ecchymoses were noted on the skin of the scrotum. The testis was tender, firm, and hard to feel. The opposite testis appeared normal. The vital signs were stable and other systems examination was normal.
A diagnosis of torsion of the right testes was made and an emergency Doppler ultrasound arranged. Doppler study revealed gross swelling of the testis along with heterogeneous echogenicity. Subtunica fluid was noted and Doppler was absent. This confirmed the diagnosis of torsion testis. The baby was taken in for surgery immediately.
On exploration during surgery, there was no evidence of necrosis of the affected testis. The incision of the right testis caused bleeding suggesting the viability of the testis. Detorsion of the right testes was done following which it was fixed to the scrotal wall. Also, orchidopexy of the opposite testis was also undertaken. Intra-operative Doppler study revealed the return of blood supply to the testes, thus proving the success of detorsion. Post-surgery, the baby was stable. He was discharged after 2 days and asked to return after a week for follow up. On follow up, the examination of the testes was normal.