Spigelian-Cryptorchidism Syndrome in Pediatrics: Diagnostic Value of Ultrasound and Magnetic Resonance Imaging

The Spigelian hernia-cryptorchidism syndrome is a rare clinical entity observed in male neonates. It is characterized by a congenital defect in the Spigelian fascia, resulting in a hernia along the semilunar line, often associated with intestinal obstruction. A hallmark feature is the presence of an ectopic testis, typically located within or immediately adjacent to the hernia sac. This association suggests a developmental anomaly involving both the abdominal wall structures and the genitourinary system. We present the case of a male infant with a history of surgically corrected Tetralogy of Fallot, in whom multiple congenital anomalies were identified, including sacral agenesis type IV, spina bifida, tethered cord, and a horseshoe kidney. During evaluation, a Spigelian hernia containing an undescended left testis was detected, along with a retractile right testis. The diagnosis was initially made by ultrasound and subsequently confirmed by magnetic resonance imaging (MRI), allowing for detailed assessment of the associated anomalies and precise surgical planning. The patient underwent successful surgical management with a favorable outcome. This case illustrates the diagnostic value of imaging, particularly ultrasound and MRI, in identifying rare and complex associations of congenital anomalies, and it highlights the importance of a multimodal imaging approach in guiding timely and effective treatment.