Torsion of a Cryptorchid Testicle

Tank is a 5-month-old male intact boxer who presented to the Emergency Service for acute vomiting and abdominal pain. The vomiting began about 12 hours before presentation. The referring veterinarian had obtained abdominal radiographs and was suspicious of a gastric foreign body. There was no other history of medical problems with Tank.

 

On physical examination, Tank was quiet but responsive, ambulatory, and mildly dehydrated. He was painful on abdominal palpation, especially in the mid to caudal abdomen. Only one testicle was palpable in his scrotum, which was determined to be the right testicle. The left testicle was not palpable in the inguinal area.

 

A complete blood count and serum chemistry profile revealed no significant abnormalities. On review of the referring veterinarian's abdominal radiographs, we did not find evidence of a gastric foreign body or other abnormality. 

 

Abdominal ultrasound revealed a structure that appeared to be a testicle. (Fig 1)

Fig 1: Abdominal ultrasound showing a cryptorchid testicle (arrow)

Placement of the ultrasound probe on the structure elicited severe pain. We were concerned that Tank had torsion of the abdominal cryptorchid testicle. 

 

A left paramedian abdominal exploratory was performed. Torsion of the left retained testicle was confirmed, and the testicle was removed.

Fig. 2: Surgical removal of the abdominal testicle

 

The descended testicle was also removed. 

Fig. 3: Both testicles removed from Tank, normal on the right, testicular torsion on the left

Tank made an unremarkable recovery from anesthesia and surgery and was discharged from the hospital the following day. 

 

Cryptorchidism is a common congenital anomaly in male dogs. One or both testicles can be retained in the inguinal region, inguinal canal, or abdomen. For more details on surgery for this disorder, see https://drstephenbirchard.blogspot.com/2014/07/cryptorchidism-in-dogs-5-ways-to-make.html, and scan the QR code for a complete discussion of cryptorchidism in dogs and cats.