Torsion of the spermatic cord is a recognized surgical emergency at any age, but has peak incidence in the neonatal and adolescent pediatric age groups.1 Perinatal unilateral torsion is well documented and the subject of a recent excellent review.2 Bilateral intrauterine torsion of the spermatic cord, however, is a rare event—to our knowledge, only five cases have been reported.3-7 We report a sixth case of intrauterine bilateral spermatic cord torsion with a markedly atypical presentation.
Report of a Case.—A 3,465-g full-term male infant was born to a 24-year-old, gravida 2, para 1, blood type O+ mother after an uncomplicated pregnancy and labor. Meconium-stained amniotic fluid was observed at the time of vaginal delivery. There was no respiratory distress. Apgar scores were 6 at one minute and 9 at five minutes. Enlarged testicles were noted at delivery.
Physical examination revealed a full-term, appropriate for gestational age,