XOẮN TINH HOÀN ẨN TRONG Ổ BỤNG Ở TRẺ SƠ SINH: BÁO CÁO CA BỆNH VÀ TỔNG QUAN Y VĂN

Abstract

Objective: Intra‐abdominal torsion ofs undescended testis in neonate is an exceedingly rare disease, often diagnosed and treated belatedly. We herein present a case of intra‐abdominal testicular torsion in a 30‑day‑old infant that was laparoscopically treated at Hanoi Children’s Hospital. Methods: Case report and comprehensive literature review. Results: A 30‑day‑old male infant was admitted for cough, poor feeding and was initially managed in the neonatal unit under observation for bronchopneumonia. A comprehensive abdominal ultrasound revealed a 20 × 30 mm heterogeneous mass in the right iliac fossa, exhibiting peripheral hypervascularity without intralesional blood flow. Surgical consultation noted absence of the right testis in both the scrotum and inguinal canal, with mild abdominal distension. Suspecting torsion of an undescended testis, an abdominal CT scan was obtained, confirming a 20 × 30 mm hypodense right iliac fossa lesion with poor postcontrast enhancement and absence of the right testis in its normal canalicular and scrotal positions—findings consistent with intra‐abdominal testicular torsion. Laparoscopic exploration revealed an enlarged, dusky right testis adherent to the peritoneum of the right iliac fossa; upon mobilization, the spermatic cord was found twisted twice around its axis, with near‐complete vascular compromise. Intraoperative diagnosis was torsion of an intra‐abdominal undescended testis with irreversible infarction. The necrotic testis was resected. The postoperative course was uneventful, and the patient was discharged on postoperative day 3. Conclusion: Torsion of an intra‐abdominal undescended testis in neonates is challenging to diagnose promptly. Ultrasonography and CT imaging can facilitate early detection. Early laparoscopic exploration should be pursued in suspected cases to establish the diagnosis and permit definitive management.