Transverse Testicular Ectopy and an Incarcerated Inguinal Hernia in a 2-Month-Old Preterm Boy

Transverse testicular ectopy (TTE) is a rare anomaly in which both testicles descend through the same inguinal canal. Different variants of this anomaly exist, with the most common presenting as two separate spermatic cords and testicular vessel bundles. The management of this condition is challenging, as various factors have to be considered. We report on a 2-month-old preterm boy with TTE, admitted to the hospital due to an ipsilateral incarcerated inguinal hernia. Diagnostic workup included a physical examination revealing a large swelling in the right groin, ultrasound imaging that showed both testicles located in the right inguinal canal, and laboratory tests indicating a deficiency of anti-Mullerian hormone. All of these findings confirmed the diagnosis of TTE. Surgical treatment included diagnostic laparoscopy with herniorrhaphy, followed by inguinal revision with transseptal orchidopexy in a second procedure. The 12-month follow-up was uneventful. Though rare, TTE is an important differential diagnosis in case of an incarcerated hernia combined with (contralateral) empty scrotum. Pediatric surgeons must be aware of this entity. Meticulous diagnostic workup and careful surgical management are mandatory.