Left Testicular Torsion in an Undescended Left Testis in a 5-Year-Old Boy: A Case Report

Purpose: Testicular torsion is a urological emergency characterized by the twisting of the spermatic cord structures, and subsequent loss of blood supply to the ipsilateral testis leading to testicular ischemia and infarction. This condition, if not promptly treated, can result in permanent testicular damage. Within 6 hours from onset of testicular pain, testicular exploration is recommended.While testicular torsion is common in normally descended testes, its occurrence in an undescended testis is rare and poses unique diagnostic and management challenges. Methodology: A 5-year-old male presented with a 6-hour history of severe left groin pain. Clinical examination revealed an empty left Hemiscrotum and a tender left groin swelling. Doppler ultrasound confirmed the absence of the left testis in the scrotum, locating it in the left groin with markedly reduced blood supply, suggestive of testicular torsion. Laboratory investigations, including a complete blood count, were within normal limits. Urgent surgical intervention involved detorsion and bilateral orchidopexy, leading to complete resolution of symptoms and an uneventful recovery. Findings: This case highlights the diagnostic difficulties associated with testicular torsion in an undescended testis. The rarity of this condition necessitates heightened clinical suspicion in patients with cryptorchidism presenting with acute abdominal or groin pain. Relevant literature and case reports emphasize the importance of early diagnosis and treatment to salvage the affected testis. Doppler ultrasonography is the diagnostic modality of choice, though clinical suspicion should guide management due to the possibility of false negatives. Surgical intervention remains the definitive treatment, with timely detorsion and orchidopexy being crucial for favorable outcomes. Unique Contribution to Theory, Practice and Policy: Testicular torsion in an undescended testis requires prompt recognition and multidisciplinary management to prevent long-term complications such as infertility. Clinicians should maintain a high index of suspicion for this condition in pediatric patients presenting with inguinal swelling and ipsilateral empty hemiscrotum. Early surgical intervention is essential for the preservation of testicular function and favorable patient outcomes.