Alaqeel Suliaman Mohammed, Hakeem Anan Hassan, Almaary Jamila Obaid
Department of Pediatric Surgery, King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Am J Case Rep. 2020 Dec 7;21:e927495. doi: 10.12659/AJCR.927495.
BACKGROUND Ectopic testis is an uncommon congenital anomaly that has been reported in different sites in the body. The anterior abdominal wall is an exceptionally rare variant site for ectopic testis. The purpose of this case report is to highlight the importance of being aware of this rare clinical entity, thereby increasing the chance of preserving an ectopic testis. In addition, this case report shows how a laparoscopic approach is advantageous for better localizing and treating such rare cases, as this is the first reported case of such a condition to be managed with a laparoscopic approach. CASE REPORT This is a rare case of testicular ectopia in an unclassified abdominal wall defect mimicking a Spigelian hernia that occurred in a 1.5-year-old boy. He presented with congenital swelling of the right lower abdominal wall and an empty right hemiscrotum. Diagnostic laparoscopy was performed and the intraoperative findings suggested right testicular ectopia in the anterior abdominal wall defect. The right testis was herniated through an abnormal, unclassified, abdominal wall defect with both a closed inguinal ring and no defect in the semilunar line. Using a laparoscopic approach, the ectopic testis and hernia were managed successfully with primary hernia repair and single-stage orchidopexy. The patient's postoperative recovery was uneventful. At his 10-month follow-up appointment, he had no evidence of hernia recurrence. CONCLUSIONS As demonstrated in this case, laparoscopic surgery, which has not been used in previously reported cases of ectopic testis, aids in proper localization and repair of an anterior abdominal wall defect along with orchidopexy.
背景 睾丸异位是一种罕见的先天性异常，在身体的不同部位均有报道。前腹壁是睾丸异位极为罕见的变异部位。本病例报告的目的是强调认识这一罕见临床实体的重要性，从而增加保留异位睾丸的机会。此外，本病例报告展示了腹腔镜手术方法在定位和治疗此类罕见病例方面的优势，因为这是首例采用腹腔镜手术方法治疗该病症的报道。病例报告 这是一例发生在一名1.5岁男孩身上的罕见睾丸异位病例，该病例表现为未分类的腹壁缺损，类似半月线疝。患儿出现右下腹壁先天性肿胀及右侧阴囊空虚。进行了诊断性腹腔镜检查，术中发现提示右睾丸异位至前腹壁缺损处。右侧睾丸通过一个异常的、未分类的腹壁缺损突出，腹股沟环闭合，半月线无缺损。采用腹腔镜手术方法，通过一期疝修补和单阶段睾丸固定术成功处理了异位睾丸和疝。患者术后恢复顺利。在10个月的随访中，无疝复发迹象。结论 如本病例所示，腹腔镜手术在先前报道的睾丸异位病例中未被应用，它有助于准确地定位和修复前腹壁缺损并同时进行睾丸固定术。
