Male patient, born at 40 weeks of gestation with vaginal delivery and cephalic presentation.
The birth weight was 3,700 gr and the height was 47 cm. Urological evaluation was requested in the presence of a large bilateral enlargement.
Physical examination revealed right hemiscrotal tension hydrocele and mild left hydrocele, with positive transfixation.
The left test has normal characteristics in terms of morphology and consistency, with the right testicular consolidation being characterized by the presence of tension hydrocele.
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Blood tests showed moderate leukocytosis.
Urine sediment was normal.
Doppler ultrasound was performed adjusting both pulse rate and wall filter to the lowest ultrasound levels.
The findings were of bilateral hydrocele, being large on the right side, presenting the right test preserved arterial Doppler flow, although with a high resistance index (RI) (IR=0.82; normal echogenicity: 0.48-0.75).
The left testicle is normal on ultrasound, with a peak systolic velocity of 11 cm/s and diastolic velocity of 5 cm/s, with a RI of 0.55.
The suspicion of testicular vascular involvement was decided surgical exploration at 18 hours of birth.
Tension hydrocele without objectifying torsion of the cord was observed, appearing the pigmentation plate test and necrotic aspect, so orchiectomy was performed.
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Postoperative evolution was uneventful.
The pathological anatomy of the specimen was testicular hemorrhagic infarction.
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After eight months of follow-up the patient is asymptomatic with left hydrocele.
