<i>In utero</i>torsion of the testis: antenatal and postnatal ultrasonic appearances

Abstract

A very large number of fetal abnormalities may now be detected by antenatal ultrasound, many cases being discovered incidentally during examinations to check fetal growth and maturity. Fetal hydrocele has been previously reported, detected at 39 weeks (Conrad & Sheshagiri, 1978) and at term (Miller & Thomas, 1979). In none of these cases was there any associated testicular abnormality. We wish to report a case of in utero torsion of the testis which presented with the typical ultrasound appearances of fetal hydrocele. The ultrasound appearances of the testis after birth are described. The mother was a 23-year-old primigravida who had previously been in good health, but had a family history of diabetes. Early pregnancy was uneventful. An ultrasound examination performed on 2.12.81 confirmed the gestational age. Gestational diabetes was diagnosed at 29 weeks, following an episode of glycosuria. Insulin therapy was then commenced which produced good control of maternal blood glucose. Serial scans at fortnightly intervals were performed from this time to check the fetal growth rate. On 30.4.82, at 35½ weeks gestational age, a cystic swelling containing a small solid mass was seen projecting into the amniotic fluid close to the fetal buttock (Fig. 1). At the time this was thought to represent a fetal hydrocele. The fetus was by then large for dates both clinically and by ultrasonic measurement (gestation 35½ weeks by dates, BPD 9.75 cms, equivalent to a standard 39½ weeks ± 3/52, FAC 40 cm equivalent to a standard 40 weeks ± 4.5/52). No other fetal abnormalities were detected.