Antenatal sonographic diagnosis of testicular torsion

Antenatal testicular torsion is a well-established condition diagnosed and treated after birth. This report describes the antenatal diagnosis of testicular torsion with surgical and pathological confirmation. Antenatal and postnatal sonographic findings included enlarged testis and epipdidymis surrounded by hemorrhagic fluid organized in two concentric compartments (‘double ring hemorrhage’ image). A contralateral hydrocele with bulging of the scrotal septum towards the unaffected side were also present. Pathological examination demonstrated a recent extravaginal torsion, which is the predominant mechanism for testicular torsion in the fetus and neonate. Recognition of this phenomenon and the ultrasonographic images associated with it may enable the diagnosis of antenatal testicular torsion to be made on prenatal sonography of the fetus. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology