Plataras Christos, Alexandrou Ioannis, Bourikis George, Bourikas Dimitris, Christianakis Efstratios
Pediatric Surgery Clinic, Penteli's Children Hospital, Attiki, Greece.
General Surgery Department, Tzanio Hospital, Piraeus, Greece.
Pan Afr Med J. 2020 Apr 14;35:119. doi: 10.11604/pamj.2020.35.119.21129. eCollection 2020.
We present an extremely rare case of inguinal hernia coexisting with testicular ectopia in a child. Male infant 9.5 month old presented with an empty scrotum and the ipsilateral intravaginal testis lying in a high iliac crest position. When crying a moving right inguinal bulge appeared on clinical examination. This grew bigger in moments of increased abdominal pressure and seemed to move upwards towards the right ileac crest. No abdominal wall defect could be palpated. At operation a large hernia sac fixed in the area of the right iliac crest was identified. Adjacent was the fixation point of the gubernaculum and the testis was found in an ectopic location. We removed the large sac after separating the vas and vessels and the testis and we strengthened the dorsal inguinal wall and fixed the testis in a subdartos scrotal pouch. No postoperative complications happened. An undescended testis may present as an iliac crest ectopy, coexisting with moving inguinal hernia. In our case we propose that the higher position of the aponeurosis of the external oblique in combination with ectopia of gubernacular fixation in the ipsilateral scrotum may have caused the ectopic fixation of the sac in the ipsilateral inguinal crest.
我们报告了一例极为罕见的儿童腹股沟疝与睾丸异位并存的病例。一名9.5个月大的男婴阴囊空虚，同侧睾丸位于髂嵴高位。临床检查时，哭闹时右侧腹股沟区出现可移动的肿块。在腹压增加时肿块增大，并似乎向上朝右髂嵴移动。未触及腹壁缺损。手术中发现一个大疝囊固定在右髂嵴区域。相邻处是睾丸引带的固定点，睾丸位于异位位置。我们在分离输精管、血管和睾丸后切除了大疝囊，并加强了腹股沟后壁，将睾丸固定在肉膜下阴囊袋中。术后未发生并发症。隐睾可能表现为髂嵴异位，并与可移动的腹股沟疝并存。在我们的病例中，我们认为腹外斜肌腱膜位置较高，结合同侧阴囊内睾丸引带固定异位，可能导致疝囊在同侧腹股沟嵴异位固定。
