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Case of the Month

March 2005

Patient Data: Male neonate

Clinical Info: Red swollen scrotum

Transverse view of the scrotum with an abnormal aspect of the left and right testicle.

This transverse view shows a swollen inhomogeneous left testicle and an abnormal small inhomogeneous right testicle with calcifications in the tunica vaginalis.

The color doppler shows only vascularization in the scrotal wall, but not in the right and left testicle.

Longitudinal magnification view of the right testicle with a rim of calcifications in the tunica vaginalis.

Longitudinal view of the left testicle with an inhomogeneous aspect caused by necrosis. Both testicles have the characteristics of a chronic testicular torsion. The testicular torsion takes place in utero. When the patient is born it is already too late for surgical treatment. The neonate was referred to a university hospital for children where they decided to do a surgical exploration. The diagnosis bilateral chronic neonatal testicular torsion with necrosis of the testicles was confirmed.

Another less dramatic cause of a swollen scrotum in a neonate is a communicating hydrocele. This transverse image shows a normal homogeneous left and right testicle surrounded by fluid.

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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