September 1993

Perinatal Acute Scrotum: Controversies in the Management of Torsion of the Testis

Author Affiliations

Department of Neonatology ORLY PRAT, MD Department of Urology Shaare Zedek Medical Center Jerusalem, 91031 Israel

Am J Dis Child. 1993;147(9):933-934. doi:10.1001/archpedi.1993.02160330023008

Sir.—Perinatal testicular torsion presenting with signs of an acute scrotum is a very rare condition, and bilateral disease is even more unusual. Review of the literature indicates that there is still controversy about optimal management. We report herein two cases that support the approach of emergency surgery.

Patient Reports.—Patient 1.—A 3930-g full-term boy was born vaginally after an uneventful pregnancy. The Apgar score was 9 at 1 and 5 minutes. On ultrasound examination 1 week before delivery, a bilateral hydrocele was detected. The results of physical examination at birth were normal except for the bilateral hydrocele and discoloration of the entire scrotum. Owing to the persistence of the discoloration, surgical exploration was performed at age 5 hours. Both testes were found to be dark and edematous. No external torsion was noted. After warming, the color of the testes became normal. Biopsy of the left testis revealed an

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