ISCHEMIC NECROSIS OF THE TESTIS WITHOUT T ORSION IN A NEONATE WITH ANTITHROMBIN-III DEFICIENCY

There have been few reports of neonatal ischemic necrosis of the testi s without torsion of the spermatic cord, which may be caused either by compression in utero or by transient torsion of the spermatic cord re solving spontaneously before surgery. The patient reported herein deve loped an inflammatory swelling of the right scrotum and an ecchymotic plaque over the left thigh at four days of age. Ischemic necrosis of t he right testis without torsion was found upon surgery. When the patie nt was ten days of age, he developed an inflammatory swelling in the l eft scrotum ; ischemic necrosis of the left testis without torsion was again found upon surgery. Thrombosis of the spermatic vessels was sus pected. Postoperatively, ecchymotic and necrotic skin lesions develope d, followed by pulmonary embolism and cerebral thrombosis. Outcome was fatal. Hematologic tests in the neonate and his parents established t he diagnosis of inherited antithrombin Ill deficiency. Ischemic necros is of the testes was thus probably due to hypercoagulability. No simil ar cases have been reported to date.