Ultrasonography is unnecessary and misleading in evaluating boys with a nonpalpable testis and can be a cause of a legal process.
A 2-year-old boy came to our attention for a left non-palpable testis (NPT). The parents asked us to perform a laparoscopy to pull down a left intrabdominal testis (IAT), identified ultrasonographically before surgery. The ultrasonography (US) performed in another institution showed a right intrascrotal testis of normal size and a left IAT of 0.85 × 0.78 mm(2) located near the internal inguinal ring. We performed a laparoscopy that showed a blind-ending vas deferens and blind-ending inner spermatic vessels as in case of vanishing testis and a large lymphnode located near the internal inguinal ring that was closed. Parents were disappointed after laparoscopic diagnosis because the US performed before surgery showed them an IAT; for this reason they undertook a legal challenge against the pediatrician and the radiologist who had given them false information. In conclusion, we believe that in cases of NPT, laparoscopy is the gold standard for diagnosis and US is unnecessary and misleading.
Department of Pediatrics, Pediatric Surgery Unit, Federico II University of Naples, Italy.
Ciro
C
Esposito
Maria
M
Escolino
Antonio
A
Savanelli
Francesca
F
Alicchio
Agnese
A
Roberti
Alessandro
A
Settimi
D002675:Child, Preschool; D003456:Cryptorchidism / Q000000981:diagnostic imaging*; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence*; D006061:Gonadal Dysgenesis, 46,XY / Q000175:diagnosis*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011300:Preoperative Care; D013737:Testis / Q000002:abnormalities*; D014463:Ultrasonography
children; laparoscopy; non-palpable testis; ultrasonogoraphy