ABSTRACT
Torsion of the neonatal testis is a well-recognized clinical
entity which accounts for about 10% of all cases of testicular
torsion admitted to pediatric surgical centers.1 Torsion
usually occurs extravaginally, i.e. in the spermatic cord above
the insertion of the tunica vaginalis (Fig. 104.1), but both
intravaginal and mesorchial torsion are reported.2,3 Either
testis may be involved. Bilateral torsion occurs and may be
synchronous or metachronous.4,5 Asynchronous torsion may
occur in as many as 33% of cases.6 Apparent primary
infarction of the neonatal testis in the absence of torsion
occurs less commonly,7 and while it has been postulated that
this represents previous torsion that has untwisted, good
evidence exists to suggest that the initial event in neonatal
torsion is a vascular one and that torsion may occur
secondarily.2 The neonatal testis may be prone to extravaginal
torsion because of its extreme mobility within the scrotum.8
Neonatal torsion appears to be a condition of large term
babies2 and it rarely, if ever, affects the preterm infant.
Previously, breech delivery was suspected as being a causative
factor. Recent reports, however, fail to confirm this.2 Affected
