International Journal of Clinical Case Reports 2017, Vol.7, No.4, 15-18
15
Case Report Open Access
A Rare Variant of Inguinal Hernia: Cryptorchid Testis at the Age of 60: An
Unusual Case Report
Pradipta Das
1
, Abhishek Singh Nayyar
2
1 Department of Surgery, Kalinga Institute of Medical Sciences, Patia, Bhubaneswar, Odisha, India
2 Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani,
Maharashtra, India
Corresponding author email
International Journal of Clinical Case Reports 2017, Vol.7, No.4 doi
Received: 18 Jan., 2017
Accepted: 24 Feb., 2017
Published: 10 Jun., 2017
Copyright © 2017
Das and Nayyar, This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Das P., and Nayyar A.S., 2017, A rare variant of inguinal hernia: Cryptorchid testis at the age of 60: An unusual case report, International Journal of
Clinical Case Reports, 7(4): 15-18 (doi
Abstract
Cryptorchidism is characterized by the extra-scrotal position of the testis. Although inguinal hernia is frequent,
cryptorchid testis at the age of 60 years is an uncommon entity. We wish to present this extremely rare case of inguinal hernia, which
is the first one that we have encountered in our practice, along with the accompanying prognosis and therapeutic issues and a review
of the literature.
Keywords
Cryptorchidism; Extra-scrotal position; Inguinal hernias
Background
Cryptorchidism is characterized by the extra-scrotal position of the testis. Cryptorchidism in a 60 years old adult
male is rare. Although inguinal hernia is frequent, cryptorchid testis at the age of 60 years is an uncommon entity.
The cryptorchid testis is characterized by the extra-scrotal position of the testis (Longui, 2005).This case report
demonstrates the utility to understand the surgical anatomy of inguinal hernias. We wish to present this extremely
rare case of inguinal hernia, which is the first one that we have encountered in our practice, along with the
accompanying prognosis and therapeutic issues and a review of the literature.
1 Case Report
We report the case of a 60 years old adult male patient who was admitted due to left inguinal hernia. His medical
history was not found to be relevant. Patient was referred with an inguinal hernia with recurrent severe colicky
pain on appearance of hernia. When the patient used to cough, the hernia used to appear. Physical examination
revealed left inguinal hernia. The scrotum showed absence of left testis in the pre-operative period (Figure 1). The
diagnosis was left inguinal hernia with absent left testis. The rest of the examination was unremarkable. He had no
known history of testicular disease. The patient did not have a problem of infertility. Surgical exploration revealed
the presence of cryptorchid testicle in inguinal hernia. The left testis with its overlying tunica vaginalis was found
at the deep inguinal ring. A viable normal sized testis was found in the hernial sac with its blood vessels and vas
deferens. The testicle was viable. Left testicle was resected for the fear of malignancy. The hernia sac was, also,
resected (Figure 2; Figure 3; Figure 4; Figure5). Surgical correction was made and the hernia was repaired using a
synthetic mesh (Lichtenstein Hernioplasty) (Figure 6; Figure 7). Histopathological examination confirmed a
normal testis and the presence of Leydig cells and the seminiferous tubule without testicular germ cell tumor
(TGCT). The patient tolerated the procedure well and the post-operative period was uneventful.
