[Funicular torsion with testicular necrosis in the newborn]

Three cases of extravaginal torsion of the spermatic cord with infarct of the testicle in the newborn are presented. All three cases had acute fetal distress. They had in common being the products of multiparous women, born in a distocic fashion with a prolonged labor without prenatal control. One of the had a shoulder impaction with required forceps use. Two of them were delivered on vaginal way and the other one by cesarean section. In all three cases, torsion was present at birth. Diagnosis was made between third and fifth day of life; the clinical findings were: enlargement of the right scrotal bag, purple discoloration of the skin, a painless hard mass that did not permit the passage of light (transillumination) and the absence of cremasteric reflex. A right resolution ultrasound was useful in determining the inflammatory tumoral mass. A right orchidectomy and pexy of the contralateral testicle were done in the three cases with nonabsorbable sutures and no testicular implants. The following diagnoses should be discarded prior to a definitive diagnosis: scrotal edemas, hydrohematocele, strangled inguinal hernia with infarct and testicular neoplasia.