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Appendicular Perforation in a Neonate Masquerading as Testicular Torsion
Nelby George Mathew1, T Abiramalatha, Harshjeet Singh
1Departments of Neonatology and *Paediatric Surgery, Christian Medical College, Vellore, Tamilnadu, India. Correspondence to: Dr Sridhar Santhanam, Professor, Department of Neonatology, 3rd floor; ISSCC Building, Christian Medical College, Vellore, Tamilnadu, India. santhanamsridhar@gmail.com.
Background:
Neonatal appendicitis is difficult to diagnose, and is associated with high mortality.
Case Characteristics:
A preterm (33 wk) neonate developed abdominal distension feeding intolerance and erythema of left inguinal region on day 4 of life.
Observation:
Testicular torsion was suspected but inguinal exploration revealed normal testis with feco-purulent fluid draining into processus vaginalis from peritoneal cavity. Laparotomy revealed inflamed and perforated appendix. Appendectomy and intravenous antibiotics led to a recovery.
Message:
Appendicitis in a neonate can rarely present with inguinal symptoms, masquerading as testicular torsion.
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