Extravaginal torsion is frequently observed in undescended testicle cases and newborns while 95% of the testicular torsions are seen during puberty except newborn are in the form of intravaginal torsion. Few cases of intravaginal torsion in the neonatal period have been reported in the literature (2,3).
Right intravaginal torsion and testicular gangrene were observed during the exploration (Figure 2).
Testicular torsion beyond the neonatal period (1 month of age and older) is an intravaginal torsion. Intravaginal torsion involves twisting of the spermatic cord within the tunica vaginalis (but does not include the tunica vaginalis) and more commonly affects the left side (Basta et al., 2015; Jefferies et al., 2015; Sharp et al., 2013).
Neonatal torsion is more commonly an extravaginal torsion involving the spermatic cord, testis, and tunica vaginalis versus the more common intravaginal torsion involving only the spermatic cord and testis.
In extravaginal torsion, the spermatic cord and testis twist along with the tunica vaginalis, while in intravaginal torsion
, the spermatic cord and testis twist inside the tunica vaginalis.
Our patient had intravaginal torsion
which is observed more rarely.
With intravaginal torsion
, which is most common in the adolescent, all of the intravaginal contents torse except for the tunica.
The surgical exploration of the scrotum revealed a non-viable left testis with 1080-degree intravaginal torsion
is more common and is due to a bell-and-clapper deformity in which the tunica vaginalis has an abnormally high insertion on the spermatic cord and completely encircles the testis, leaving the testis free to rotate within the tunica vaginalis.
Testicular torsion presents in a bimodal age presentation, with extravaginal torsion occurring in the perinatal period and intravaginal torsion
peaking in puberty, although the latter can be seen at any age.[sup.1]-[sup.3] It is unusual to see testicular torsion in the first few months of life, but it is still possible and it should be on the differential diagnosis list.