Thambidorai C R, Khaleed A
Department of Surgery, University Kebangsaan Malaysia Hospital, 56000 Kuala Lumpur, Malaysia.
Pediatr Surg Int. 2008 Mar;24(3):371-4. doi: 10.1007/s00383-007-1932-8. Epub 2007 May 10.
Two patients with unilateral transverse testicular ectopia (TTE) without the persistence of Mullerian duct structures are described. Each presented with unilateral impalpable testis and a contralateral inguinal hernia. The diagnosis of unilateral TTE was made during laparoscopic evaluation for undescended testis. The first patient had unilateral TTE on the right side and the second on the left. In both patients, a long thin band resembling the round ligament of the uterus was seen extending from the region of the internal inguinal ring (IIR) on the side of the undescended testis to the opposite inguinal canal. In both patients, there was no patent processus vaginalis on the side of the undescended testis and on the contralateral side the internal rings were widely patent with large hernial sacs. In the second patient, the right vas was seen extending from the right IIR towards the right side of the pelvis. The right vas showed a short segment of discontinuity at the level of the right IIR while its proximal end extended into the left inguinal canal in close relation to the right spermatic vessels. The vasal anomaly was probably ischemic in origin, resulting from excessive mobility of the ectopic testis and its vas in TTE. Correlation of the current hypotheses on the embryology of TTE with the above mentioned laparoscopic findings is discussed.
本文描述了两名患有单侧横睾异位（TTE）且苗勒管结构未残留的患者。两名患者均表现为单侧睾丸未触及及对侧腹股沟疝。单侧TTE的诊断是在对隐睾进行腹腔镜评估时做出的。第一名患者右侧为单侧TTE，第二名患者左侧为单侧TTE。在两名患者中，均可见一条类似子宫圆韧带的细长带，从隐睾侧的腹股沟内环（IIR）区域延伸至对侧腹股沟管。在两名患者中，隐睾侧的鞘状突未闭，对侧内环广泛开放，伴有大疝囊。在第二名患者中，可见右侧输精管从右侧IIR向骨盆右侧延伸。右侧输精管在右侧IIR水平显示一小段中断，而其近端与右侧精索血管紧密相关，延伸至左侧腹股沟管。输精管异常可能源于缺血，是由TTE中异位睾丸及其输精管的过度活动所致。本文讨论了目前关于TTE胚胎学的假说与上述腹腔镜检查结果的相关性。
