CLINICAL IMAGE
Snapshots in surgery: incidentally discovered cryptorchidism Margaret F. Nicholson, Rishabh Sehgal, Robert Cunningham, Sean Martin & Desmond C. Winter Department of Surgery, St. Vincent’s University Hospital, Elm Park, Dublin, 4, Ireland
Correspondence Margaret F. Nicholson, Department of Surgery, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland. Tel: 917-324-4925; Fax: 856-845-2474; E-mail: [email protected] Funding Information No funding information provided.
Key Clinical Message An 18-year-old was presented with a large inflamed appendix (compressed by the instrument) and a spermatic cord with right undescended testicle (cryptorchidism). Patients who undergo orchiopexy after age 12 years, or no orchiopexy, are 2–6 times as likely to have testicular cancer as those who undergo prepubertal orchiopexy. Keywords
Received: 25 February 2014; Revised: 20 May 2014; Accepted: 15 April 2014
Appendicitis, cryptorchidism, orchidectomy, orchiopexy, testicular cancer.
Clinical Case Reports 2014; 2(5): 237 doi: 10.1002/ccr3.96
Question: An 18-year-old male presented to the emergency department with a 12-h history of abdominal pain and a 2-day history of anorexia and abdominal cramps. Vital signs were T 37.1°, BP 137/88, RR 18, and HR 88. Physical examination revealed right iliac fossa guarding, rebound tenderness, and a positive Rovsing’s sign. A clinical diagnosis of appendicitis was made. What is the incidental finding shown in this intraoperative photograph? Answer: A large inflamed appendix (compressed by the instrument) and a spermatic cord with right undescended testicle (cryptorchidism). The case was converted to open due to concern of an appendiceal mucocele. Scrotal examination revealed a normal left testicle and a pea-sized mass on the right side. Histologic evaluation of the appendix showed acute appendicitis with transmural inflammation. An interval orchidectomy was performed after appropriate counseling. Patients who undergo orchiopexy after age 12 years, or no orchiopexy, are 2 to 6 times as likely to have testicular cancer as those who undergo prepubertal orchiopexy [1].
References 1. Wood, H. M., and J. S. Elder. 2009. Cryptorchidism and testicular cancer: separating fact from fiction. J. Urol. 181:452–461.
Conflict of Interest None declared.
ª 2014 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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Snapshots in surgery: incidentally discovered cryptorchidism Margaret F. Nicholson, Rishabh Sehgal, Robert Cunningham, Sean Martin & Desmond C. Winter Department of Surgery, St. Vincent’s University Hospital, Elm Park, Dublin, 4, Ireland
Correspondence Margaret F. Nicholson, Department of Surgery, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland. Tel: 917-324-4925; Fax: 856-845-2474; E-mail: [email protected] Funding Information No funding information provided.
Key Clinical Message An 18-year-old was presented with a large inflamed appendix (compressed by the instrument) and a spermatic cord with right undescended testicle (cryptorchidism). Patients who undergo orchiopexy after age 12 years, or no orchiopexy, are 2–6 times as likely to have testicular cancer as those who undergo prepubertal orchiopexy. Keywords
Received: 25 February 2014; Revised: 20 May 2014; Accepted: 15 April 2014
Appendicitis, cryptorchidism, orchidectomy, orchiopexy, testicular cancer.
Clinical Case Reports 2014; 2(5): 237 doi: 10.1002/ccr3.96
Question: An 18-year-old male presented to the emergency department with a 12-h history of abdominal pain and a 2-day history of anorexia and abdominal cramps. Vital signs were T 37.1°, BP 137/88, RR 18, and HR 88. Physical examination revealed right iliac fossa guarding, rebound tenderness, and a positive Rovsing’s sign. A clinical diagnosis of appendicitis was made. What is the incidental finding shown in this intraoperative photograph? Answer: A large inflamed appendix (compressed by the instrument) and a spermatic cord with right undescended testicle (cryptorchidism). The case was converted to open due to concern of an appendiceal mucocele. Scrotal examination revealed a normal left testicle and a pea-sized mass on the right side. Histologic evaluation of the appendix showed acute appendicitis with transmural inflammation. An interval orchidectomy was performed after appropriate counseling. Patients who undergo orchiopexy after age 12 years, or no orchiopexy, are 2 to 6 times as likely to have testicular cancer as those who undergo prepubertal orchiopexy [1].
References 1. Wood, H. M., and J. S. Elder. 2009. Cryptorchidism and testicular cancer: separating fact from fiction. J. Urol. 181:452–461.
Conflict of Interest None declared.
ª 2014 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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