Ablatt Saniya, Escobar Mauricio Antonio
Surgery, Virginia Mason Franciscan Health, Tacoma, Washington, USA.
Pediatric Surgical Services, Mary Bridge Children's Hospital and Health Center, Tacoma, Washington, USA.
BMJ Case Rep. 2025 Jan 4;18(1):e261858. doi: 10.1136/bcr-2024-261858.
Spigelian hernia and cryptorchidism syndrome in children is increasingly reported in the literature. A variety of phenotypes have been reported, so diagnostic approaches and operative techniques remain poorly defined. The case of an infant male who presented with a left spigelian hernia and ipsilateral cryptorchidism who was initially misdiagnosed with an ectopic inguinal testis is presented. He underwent diagnostic laparoscopy which revealed an ectopic left testis within the spigelian hernia defect with a gubernaculum present. Collaborative decision making between paediatric surgery and paediatric urology resulted in the final operative repair entailing laparoscopic orchiopexy, open left spigelian and inguinal hernia repair, right inguinal hernia repair and umbilical hernia repair. We conclude that a laparoscopic orchiopexy of an ectopic testis within a spigelian hernia is a safe method to address this rare phenomenon, but collaborative multidisciplinary discussion is ideal to weigh operative strategies and management.
小儿半月线疝与隐睾综合征在文献中的报道日益增多。已报道了多种表型，因此诊断方法和手术技术仍不明确。本文介绍了一名男婴病例，该男婴表现为左侧半月线疝和同侧隐睾，最初被误诊为异位腹股沟睾丸。他接受了诊断性腹腔镜检查，结果显示半月线疝缺损内有一个异位左侧睾丸，并伴有睾丸引带。小儿外科和小儿泌尿外科之间的共同决策导致了最终的手术修复，包括腹腔镜睾丸固定术、开放式左侧半月线疝和腹股沟疝修补术、右侧腹股沟疝修补术和脐疝修补术。我们得出结论，半月线疝内异位睾丸的腹腔镜睾丸固定术是处理这种罕见现象的一种安全方法，但多学科协作讨论对于权衡手术策略和管理是理想的。
