Twisted intra-abdominal cyst in a neonate: a surprise revelation

BMJ Case Rep. 2017 Aug 8:2017:bcr2017220474. doi: 10.1136/bcr-2017-220474.

Abstract

We, herein, present a male neonate with an antenatally detected intra-abdominal cyst who presented at 18 days of life at which time, the ultrasound revealed a 5×4 cm cyst. Since he was asymptomatic, we planned to repeat the ultrasound a month later and operate if the cyst showed no regression. However, a week later, he presented with an acute abdomen, irritable cry and a repeat ultrasound showing a larger (8×6 cm) cystic mass with debris within. He was taken up for an emergency laparotomy. Intraoperatively, the cyst was found arising from the left lateral abdominal wall free from all structures with a twisted pedicle. Histopathology surprisingly revealed seminiferous tubules within the cyst wall with the vas deferens, thus confirming the diagnosis of a torsion of intra-abdominal testis. Hence, we emphasise the importance of examining for an undescended testis when dealing with a male neonate presenting with a cystic intra-abdominal mass.

Keywords: congenital disorders; neonatal health; paediatrics.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / etiology
  • Abdomen, Acute / surgery
  • Abdominal Wall / diagnostic imaging
  • Cryptorchidism / diagnosis*
  • Cryptorchidism / surgery
  • Cysts / diagnostic imaging
  • Cysts / pathology
  • Diagnosis, Differential
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis
  • Laparotomy
  • Male
  • Testis / diagnostic imaging
  • Testis / pathology*
  • Torsion Abnormality / diagnostic imaging
  • Torsion Abnormality / pathology
  • Torsion Abnormality / surgery*
  • Ultrasonography