Torsed intraabdominal testis: a rarely considered diagnosis

Cryptorchidism, or maldescended testis, is a common problem encountered in pediatric age groups. Despite more than 100 years of research, many aspects of cryptorchidism are not well defined and remain controversial. However, cryptorchidism clearly has deleterious effects on the testis over time.(1-4)Among the problems associated with an undescended testis are an increased risk for testicular tumor development and a propensity for torsion. In cases of bilateral undescended testis, infertility is a concern.(1-4)Torsed intraabdominal testis is rarely considered in the differential of acute appendicitis, probably because of a failure to examine the external genitalia as part of the abdominal examination. Most patients with an undescended testis, especially adults, are aware of the absence of the testis within the scrotal sac. The purpose of this report is to highlight a case of torsed abdominal testis which presented with features of acute appendicitis in a 32 year old man who was unaware of the absence of the right testis within the right hemiscrotum.