Bilateral Undescended Testes With Unilateral Torsion Presenting As Acute Abdomen: A Case Report

TL;DR

A six-year-old boy with two undescended testes presented with an acute abdomen due to torsion in one testis, requiring surgical intervention.

Contribution

This case report highlights the rare presentation of bilateral undescended testes with unilateral torsion mimicking acute abdomen.

Findings

Bilateral undescended testes with torsion in one testis can present as an acute abdomen.

Prompt surgical management is crucial to prevent irreversible ischemic damage.

Combined laparoscopic orchidopexy and orchiectomy can be performed in a single procedure for such cases.

Abstract

Undescended testis (UDT) is the most common congenital urological anomaly. The primary concerns warranting surgical intervention include an increased risk of malignancy, infertility, and testicular torsion. Although testicular torsion is rare, it is a serious complication that can lead to ischemic injury and organ loss if not promptly diagnosed and managed. Bilateral undiagnosed UDT with torsion in an ipsilateral palpable testis is even more rarely reported. We present a similar case of a six-year-old male with bilateral undescended testes--the left being intra-abdominal and the right located in the inguinal canal with torsion--presenting with features of an acute abdomen. He was managed in a single procedure with left laparoscopic orchidopexy and right orchiectomy due to a non-salvageable ischemic testis.

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