Complete separation of the testis and epididymis presenting as inguinal hernia

Complete separation of the epididymis from the testis is a rare phenomenon. In all reported cases, both structures remained undescended. We recently managed a 2-month-old boy with bilateral inguinal hernia and complete dissociation of the epididymis from the testis on the left side. At exploration, a right indirect inguinal hernia was confirmed while on the left side, an indirect inguinal hernia was associated with an undescended abdominal testis completely separated from a normally descended epididymis. This could reflect an essential role of the epididymis in the process of testicular descensus. The diversity of congenital abnormalities possibly encountered in the inguinoscrotal region during infancy and childhood necessitates the acquisition of insightful knowledge in the pathological anatomy of this area and adequate surgical skill to avoid undesirable intraoperative confusion with its negative impact on proper diagnosis and appropriate management.