Case History/examination
The index case was 45 days old male infant born to para-III mother
delivered at home with no antenatal care follow up, historically
presented with right side abdominal distension since birth. Otherwise
the infant was fine and no other complaint. This patient vital sign and
anthropometry was normal for age. On clinical examination the abdomen is
distended and soft on the right side but normal on left side (Fig.1).
For this patient presentation abdominal ultrasound was done at our
hospital.
On ultrasound left side abdominal wall muscles (both rectus abdominis
and oblique muscles) were visualized with normal thickness and
echotexture (Fig.2). Right side of midline no abdominal wall muscles
visualized (Fig.2). Bowel loops wall was visualized just beneath the
abdominal wall subcutaneous tissue. On further assessment only left
testis was visualized in scrotal sac with minimal surrounding fluid.
Right scrotal sac was not developed and the right testis was not
visualized in inguinoscrotal region (Fig.3A). There was 9mm by 7mm
measuring oval shaped structure seen in right side of retroperitoneum
anterior to right psoas muscle just below the renal hilum (Fig.3B). The
oval shaped structure has similar shape and echotexture to left side
intrascrotal testis. Bilateral kidneys are located in normal position
with no evidence of hydronephrosis (Fig 4A).The urinary bladder was
minimally distended with urine (estimated volume of 20cc) with normal
wall thickness (Fig.4B).