A 7-year-old male Siberian husky was presented with signs of acute abdomen. Based on the history and diagnostic imaging findings, torsion of an undescended abdominal testis was presumed. Emergency exploratory laparoscopy was performed and confirmed spermatic cord torsion in a non-neoplastic testis. The testis was enlarged and local peritonitis was evident. Laparoscopic cryptorchidectomy was performed and the dog recovered uneventfully. Histopathology confirmed thrombosis and necrosis. Laparoscopy is not only the method of choice for elective cryptorchidectomy, but can also be used in patients with acute abdomen from testicular torsion of an undescended testis.
Torsion, undescended testis, minimally invasive surgery, peritonitisCryptorchidism is the most common congenital anomaly of the testes with a reported prevalence of 0.8-15% (Cox et al. 1978). Reported incidence for the Siberian husky is approximately 14% (Zhao et al. 2010). It can occur unilaterally or bilaterally and the undescended testis may be located in the abdominal cavity, inguinal canal, or in an ectopic subcutaneous location between the superficial inguinal ring and the scrotum (Evans and Christensen 1993).When both testes are retained, the dog will be infertile due to thermal-induced testicular hypoplasia (Birchard and Nappier 2008). Cryptorchidism is also a risk factor for the development of testicular neoplasia in dogs (Yates et al. 2003). One study found the risk to develop a tumour in cryptorchid testes 13.6 × as high as the risk in scrotal testes (Hayes and Pendergrass 1976). Another complication of cryptorchidism is testicular torsion. Torsion of the spermatic cord clinically manifests as an acute abdomen, and immediate therapy is indicated (Pearson and Kelly 1975).Minimally invasive surgery has become increasingly popular in veterinary medicine and is often recommended as the preferential treatment method for elective procedures (Matyjasik et al. 2011;Zhang et al. 2014). Laparoscopic or laparoscopic-assisted cryptorchidectomy is recommended for elective removal of retained testis in dogs and cats because of the decrease in morbidity rates, improved visualization, and safety (Miller et al. 2004;Mayhew 2009;Runge et al. 2014). Descriptions of emergency laparoscopic procedures in veterinary medicine are, however, rare and the use of laparoscopic cryptorchidectomy for acute testicular torsion has not yet been described. Physical examination revealed compensatory stage of shock (hyperaemic oral mucosa, decreased capillary refill time, mild tachycardia, and severe tachypnea). Only the left testis was present in the scrotum and abdominal palpation elicited an intense pain response. Complete blood count and biochemistry tests did not reveal any abnormality.
Case descriptionAbdominal radiographs were taken to determine the origin of the acute abdomen (Plate V, Fig. 1A, B). A spherical soft tissue opacity mass localized cranially to the urinary bladder was detected. Abdominal ultrasound identified a mild amount of anechoic effusion in the le...