Unilateral testicular torsion in a neonate

A male neonate born at gestational age of 40 weeks was found to have an enlarged and darkened right hemiscrotum after birth. Left testicle was descended and normal. No clinical signs of distress were evident. A color Doppler ultrasound showed an absence of testicular blood flow, consistent with perinatal testicular torsion. The patient underwent a bilateral scrotal exploration through an inguinal incision and a necrotic right testicle was found. A right orchiectomy and left orchiopexy were performed. perinatal testicular torsion is a rare but severe condition. A high clinical suspicion is required since most of perinatal testicular torsion are intrauterine and can often be asymptomatic, only with localized findings of the affected testis. The management of perinatal testicular torsion is still controversial, however the most consensual approach is a prompt testicle exploration with orchiectomy of the necrotic testicle and contralateral orchiopexy.