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Splenogonadal Fusion Presenting as Acute Torsion of Testis

Received: 1 June 2017     Accepted: 17 August 2017     Published: 10 October 2017
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Abstract

Splenogonadal fusion (SGF) is a rare congenital anomaly noticed mainly in boys. The usual presentation is of testicular swelling and is managed most of the time with avoidable orchidectomy. Here we report a case of SGF in a one year old boy presenting with tender swelling on the left inguinal region and empty left scrotum. With the suspicion of torsion left inguinal testis, left inguinal exploration with laparoscopy was done as emergency procedure. It revealed left inguinal testis adherent to a torted segment of continuous type of spleenunculi which extended up to the spleen intra abdominally. Child underwent excision of this splenunculi with left orchidopexy. Pathology of the specimen was reported as torsion of splenunculi. Most of the SGF are incidental finding that are noticed during elective herniotomy or orchidopexy. But there are few cases reported in literature where SGF can present as an acute condition mimicking torsion of testis. A testis preserving excision of splenunculi should be done in these patients as there is usually a clear demarcating plane between them.

Published in American Journal of Pediatrics (Volume 3, Issue 5)
DOI 10.11648/j.ajp.20170305.11
Page(s) 28-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Splenunculi, Torsion, Orchidectomy, Intra Abdominal

References
[1] Putschnar WG, Manion WC. Splenogonadal fusion. AM. J. Pathol. 1956: 32 15-33.
[2] Splenogonadal fusion-limb deformity syndrome: a rare but important cause of undescended testis Ahmet Celik, Sibel Tiryaki, Sukran Darcan, Orkan Ergun Izmir, Turkey World J Pediatr, Vol 12 No 2. May 15, 2016. www.wjpch.com
[3] Sneath W. A. Apparent third testicle consists of a scrotal spleen. J. Anat physiol. 47: 340.1913.
[4] Carraghan A. M. One hundred cases of splenogonadal fusion. Urology 1990: 35, 471-5.
[5] Shen XC, Duc J, Chen JM, Zhang ZW, Qiu YQ. Splenogonadal fusion. Chin. med. Journal. 2008. 121, 383-4.
[6] Meneses M. F, Ostowski M. L. Female spleno-gonadal fusion of the discontinuous type. H. M pathol 20: 486, 1989.
[7] Khairat AB, Ismail AM. Splenogonadal fusion case presentation and literature review. J. Pediatr. Surg 2005: 40, 1357-60.
[8] Falkowski W. S, Carter M. F. Splenogonadal fusion associated with an anaplastic seminoma. J. Urol 124: 562, 1980.
[9] Imperial SL, Sindhu JS. Non seminomatous germ cell tumour arising in spleno-gonadal fusion. Arch. patho lab. med 2002; 126 1222-5.
[10] Malik RD, Liu DB. Splenogonadal fusion: An Unusual case of acute scrotum. Rev. Urol 2013: 15 197-201.
[11] “Rosary of Testes”: Splenogonadal Fusion in Association with Bilateral Abdominal Testes Presenting as Polyorchidism. Pejman Shadpour et al. Case Reports in Urology Volume 2015 (2015), Article ID 317189, 3 pages, http://dx.doi.org/10.1155/2015/317189
[12] Splenogonadal Fusion, Francis M. Patafio et al. Canadian Association of Radiologists Journal 62 (2011) 302-304.
[13] Splenogonadal fusion: Case report and review of literature R. Fernandez Atuan et al, J Ped Surg Case Reports Volume 1, Issue 10, October 2013, Pages 375-377.
[14] Splenogonadal fusion and testicular cancer: case report and review of the literature Roberto Iglesias Lopes et al, Einstein (São Paulo) vol. 10 no. 1 São Paulo Jan./Mar. 2012 http://dx.doi.org/10.1590/S1679-45082012000100019
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  • APA Style

    Sam Aruputha John, Ahamed Faiz Ali, Sunil Kumar, Rasha Kassem, Ali Hussain Ashkanani, et al. (2017). Splenogonadal Fusion Presenting as Acute Torsion of Testis. American Journal of Pediatrics, 3(5), 28-31. https://doi.org/10.11648/j.ajp.20170305.11

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    ACS Style

    Sam Aruputha John; Ahamed Faiz Ali; Sunil Kumar; Rasha Kassem; Ali Hussain Ashkanani, et al. Splenogonadal Fusion Presenting as Acute Torsion of Testis. Am. J. Pediatr. 2017, 3(5), 28-31. doi: 10.11648/j.ajp.20170305.11

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    AMA Style

    Sam Aruputha John, Ahamed Faiz Ali, Sunil Kumar, Rasha Kassem, Ali Hussain Ashkanani, et al. Splenogonadal Fusion Presenting as Acute Torsion of Testis. Am J Pediatr. 2017;3(5):28-31. doi: 10.11648/j.ajp.20170305.11

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  • @article{10.11648/j.ajp.20170305.11,
      author = {Sam Aruputha John and Ahamed Faiz Ali and Sunil Kumar and Rasha Kassem and Ali Hussain Ashkanani and Nawal Yakoub Akbar},
      title = {Splenogonadal Fusion Presenting as Acute Torsion of Testis},
      journal = {American Journal of Pediatrics},
      volume = {3},
      number = {5},
      pages = {28-31},
      doi = {10.11648/j.ajp.20170305.11},
      url = {https://doi.org/10.11648/j.ajp.20170305.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20170305.11},
      abstract = {Splenogonadal fusion (SGF) is a rare congenital anomaly noticed mainly in boys. The usual presentation is of testicular swelling and is managed most of the time with avoidable orchidectomy. Here we report a case of SGF in a one year old boy presenting with tender swelling on the left inguinal region and empty left scrotum. With the suspicion of torsion left inguinal testis, left inguinal exploration with laparoscopy was done as emergency procedure. It revealed left inguinal testis adherent to a torted segment of continuous type of spleenunculi which extended up to the spleen intra abdominally. Child underwent excision of this splenunculi with left orchidopexy. Pathology of the specimen was reported as torsion of splenunculi. Most of the SGF are incidental finding that are noticed during elective herniotomy or orchidopexy. But there are few cases reported in literature where SGF can present as an acute condition mimicking torsion of testis. A testis preserving excision of splenunculi should be done in these patients as there is usually a clear demarcating plane between them.},
     year = {2017}
    }
    

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    AU  - Sam Aruputha John
    AU  - Ahamed Faiz Ali
    AU  - Sunil Kumar
    AU  - Rasha Kassem
    AU  - Ali Hussain Ashkanani
    AU  - Nawal Yakoub Akbar
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    DO  - 10.11648/j.ajp.20170305.11
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    EP  - 31
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20170305.11
    AB  - Splenogonadal fusion (SGF) is a rare congenital anomaly noticed mainly in boys. The usual presentation is of testicular swelling and is managed most of the time with avoidable orchidectomy. Here we report a case of SGF in a one year old boy presenting with tender swelling on the left inguinal region and empty left scrotum. With the suspicion of torsion left inguinal testis, left inguinal exploration with laparoscopy was done as emergency procedure. It revealed left inguinal testis adherent to a torted segment of continuous type of spleenunculi which extended up to the spleen intra abdominally. Child underwent excision of this splenunculi with left orchidopexy. Pathology of the specimen was reported as torsion of splenunculi. Most of the SGF are incidental finding that are noticed during elective herniotomy or orchidopexy. But there are few cases reported in literature where SGF can present as an acute condition mimicking torsion of testis. A testis preserving excision of splenunculi should be done in these patients as there is usually a clear demarcating plane between them.
    VL  - 3
    IS  - 5
    ER  - 

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Author Information
  • Department of Pediatric Surgery, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

  • Department of Pediatric Surgery, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

  • Department of Pediatric Surgery, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

  • Department of Pediatric Surgery, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

  • Department of Pediatric Surgery, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

  • Department of Radiology, Ibnsina Hospital, Ministry of Health, Kuwait City, Kuwait

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