An Unusual Presentation of Crossed Testicular Ectopia as an Incarcerated Inguinal Hernia
A healthy 10-month-old boy was admitted to the emergency room with a painful swelling in the left inguinal region. Physical examination showed a tender 2-cm lump in the left inguinal canal. Inguino-scrotal ultrasonography in this patient showed a left inguinal hernia with two gonads in the left scrotal sac and an impalpable right non-scrotal testis (). In addition, we could not find evidence of persistent Müllerian duct syndrome, which is characterized by the presence of a uterus and fallopian tubes in abdominal ultrasonography. There was no evidence of developmental malformations of the external genitalia, such as hypospadias, bifid scrotum, or micropenis. After urgent manual reduction for an incarcerated inguinal hernia, left inguinal exploration was undertaken. A thin-walled inguinal hernial sac was found, containing two normal-sized and normal-shaped testes that were attached to one gubernaculum from the left inguinal ring (). Each had its own blood supply and had separate vasa deferentia. After left inguinal herniorrhaphy, the gubernaculum was divided to strengthen each of the spermatic cord without creating undue tension on either side. The left testis was placed into the left subdartos space and the ectopic right testis was fixed transseptally into the right subdartos space.