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Closing left gastroschisis with vanishing left testis
Ramnik V Patel1, C K Sinha, Bharat More
1Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Case Reports
|September 13, 2013
Summary
Gastroschisis can cause testicular vanishing syndrome due to vascular compromise at the abdominal wall defect. This case highlights the importance of monitoring testicular blood supply during gastroschisis repair.
Area of Science:
- Pediatric Surgery
- Neonatal Development
- Urology
Background:
- Gastroschisis is a congenital abdominal wall defect requiring surgical repair.
- Undescended testes are a known complication, with potential for testicular atrophy.
- Vascular compromise is a suspected etiology for testicular abnormalities in gastroschisis.
Observation:
- A male neonate presented with gastroschisis and a non-palpable left undescended testis.
- The umbilical cord was intact, but a defect was noted on the left side.
- Associated findings included left testicular atrophy and abnormal ductus deferens.
Findings:
- Primary repair of gastroschisis was successful with an uneventful recovery.
- Subsequent inguinal exploration revealed a blind-ending vas deferens and a vanishing left testis.
- The case supports the theory of vascular accidents at the abdominal wall defect causing testicular loss.
Implications:
- Surgical narrowing of the gastroschisis defect may compromise testicular blood supply.
- This mechanism can lead to testicular vanishing syndrome in affected neonates.
- Careful assessment of testicular vascularity during gastroschisis repair is crucial.
