iarjmcrIARJMCRIARJMCR2709-3220https://doi.org/10.47310/iarjmcr.2021.v02i02.013A Torsed Intraabdominal Testis Presenting With a Mechanical Large Intestinal Obstruction – A Maiden Case ReportMukeshKumarSangwanVijayataSangwanMohinderKumarGargDeepakSinglaAjenderSinghPushpenderMalikAssociate Prof Dept of surgery BPS Govt Med Coll for Women Khanpur Kalan Sonepat Haryana IndiaAssociate Prof Dept of Obs and Gynae BPS Govt Med Coll for Women Khanpur Kalan Sonepat Haryana IndiaProfessor Dept of surgery BPS Govt Med Coll for Women Khanpur Kalan Sonepat Haryana IndiaAssistant Prof Dept of surgery BPS Govt Med Coll for Women Khanpur Kalan Sonepat Haryana IndiaBackground: The torsion of an undescended abdominal testis is not a common entity. A mechanical large gut obstruction due to compression of large gut by a torsed intraabdominal testis is still an unreported entity in the literature to the best of our knowledge. Case presentation: A 27 years male presented in our emergency with abdominal pain for last 48 hours. The pain was gradually increasing in intensity along with a history of non-passage of stools for last 2 days. On examination, there was slight tachycardia with abdominal distension. Tenderness could be elicited in his right lower abdomen without any evidence of rebound tenderness and rigidity. His total leucocyte count was 12600/cmm along with a neutrophil count of 80.6 %. Ultrasonography revealed dilated gut loops with minimal peristaltic activity. Mild free fluid was also reported in the peritoneal cavity. His abdominal x ray reflected multiple air fluid levels suggestive of an acute intestinal obstruction. An emergency exploratory laparotomy was done. Intraoperatively, whole of small intestine and colon proximal to sigmoid colon were dilated due to compression of the later by a gangrenous right intraabdominal testis. The abdomen was closed after right orchidectomy and manual gut decompression. The patient had an uneventful postoperative recovery. Conclusions: It has been a challenging task to diagnosis a torsed intraabdominal testis preoperatively for the surgeons all over the globe. A quick history taking, missed scrotal examination and inability to use better diagnostic tools in time constrained emergency situations are the common lacunae reported in these cases. A high index of suspicion particularly in young cases of abdominal emergencies is the need of the hour for the better management of torsed intraabdominal testis.