Baca PJE, Leuchter IJ, Domínguez CLG, Mayagoitia GJC

Language: Spanish
References: 13
Page: 82-86
PDF size: 309.56 Kb.

ABSTRACT

Introduction: The finding of a testicle with acute torsion at the level of the deep inguinal ring is uncommon during a hernia repair. The androgen insensitivity syndrome or «feminizing testicle» is a recessive genetic disorder linked to chromosome X; it is characterized by the resistance of the target tissues to the action of male hormones, preventing normal male genitalia development of genetically male individuals (46, XY). We present the case of a recurrent inguinal hernia with testicular torsion in the inguinal canal. Case report: This is a phenotypically female patient of 36 years. Primary amenorrhea. A clinical history of surgery at two months of age due to a tumor in the left upper lip and right inguinal hernia repair three years ago. Seen at the emergency room for inguinal and right lower quadrant throbbing pain, progressive and increasing in intensity, accompanied by nausea and vomiting. Physical examination: Pain with pressure on the right lower quadrant and inguinal region with negative McBurney and Blumberg, a palpable mass of 3.5 × 2.5 cm on right inguinal region, extremely painful with pressure, fixed and not reducible, external genitalia without abnormalities, leukocytes count reported of 12,000. Abdominal tomography showing: Absence of uterus, ovaries and other female annexes, and a 3.5 × 2.5 cm mass in the right inguinal canal. With a diagnosis of strangulated recurrent right inguinal hernia. Then a diagnostic laparoscopic surgery was performed, finding a hematoma in the internal ring of the inguinal canal and torsion of the right testicle inside the internal ring. Orchiectomy and a TAPP hernia repair with heavy polypropylene mesh were performed. In the postoperative period, karyotype and chromatin were requested with a 46, XY and absence of Barr corpuscles results.

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