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Case of the Month

March 2005

Patient Data: Male neonate

Clinical Info: Red swollen scrotum


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


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


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


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


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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.


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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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