A rare case of testicular necrosis after sigmoidectomy for cancer

Abstract

A 64-year-old man was admitted to hospital due to left lower abdominal pain. Endoscopy and double contrast fluoroscopy, as well as CT, revealed sigmoid colon cancer with lymph node involvement. Sigmoidectomy with lymph node dissection was performed. During surgery, the tumor was found to infiltrate to the left spermatic artery, vein, and duct. The tumor was removed en bloc with lymph nodes, spermatic vessels, and duct. Two days after surgery, the patient became febrile (37.8°C) ; his left testis was swollen and painful. No blood flow signal was detected on Doppler ultrasonogram. Ischemic necrosis was confirmed clinically and removal of the left testis was performed on 4^th postoperative day.
In general, the concomitant resection of the spermatic artery during sigmoidectomy does not result in necrosis of the testis due to the presence of many collaterals. Nevertheless, our patient developed left testicular necrosis after sigmoidectomy. We report this case since this is a rare occurrence.