Splenogonadal Fusion With Polysplenia Discovered During Pediatric Inguinal Hernia Repair: A Case Report

Splenogonadal fusion is a rare congenital anomaly that may mimic an inguinal hernia or testicular tumor, often making preoperative diagnosis difficult. We report a 14-year-old boy with a left inguinoscrotal mass initially diagnosed as an inguinal hernia. During open surgery, a violaceous cord-like structure extending from the upper pole of the left testis toward the abdominal cavity was identified, prompting exploratory laparoscopy. This confirmed continuity with the spleen and revealed polysplenia, including an accessory spleen in the pancreatic tail. Laparoscopic resection of the ectopic tissue and repair of the inguinal defect were performed, and histopathology confirmed splenic tissue. This case highlights the importance of intraoperative recognition of continuous splenogonadal fusion to guide conservative management and avoid unnecessary radical surgery.