Splenogonadal Fusion Presenting as Acute Scrotum: A Case Report

Splenogonadal Fusion (SGF) is a rare congenital anomaly characterised by abnormal attachment of splenic tissue to the gonads. We report the case of a five-year-old male child presenting with an acute scrotum, initially suspected to be testicular torsion. During emergency surgical exploration of the scrotum, a gangrenous structure was discovered. This structure was connected to the left testis by a fibrous band that had undergone torsion. It also had another fibrous band at its opposite pole, with the fibrous band extending into the peritoneal cavity. Later, ultrasound confirmed its connection to the spleen. Histopathological examination confirmed the diagnosis of SGF. The patient had an uneventful postoperative course, and follow-up imaging showed normal testicular vascularity. SGF is often misdiagnosed due to its rarity, and early diagnosis through imaging and histopathology is critical in avoiding unnecessary orchiectomies and preserving gonadal function. This case underscores the need to consider SGF as a possibility whenever unusual findings are encountered during scrotal exploration.