Splenogonadal Fusion Presented as an Inguinal Hernia: A Case Report and a Literature Review

Splenogonadal fusion (SGF) is a rare congenital abnormality that occurs when the primitive spleen and the gonad fuse improperly during gestation. As a result, the gonad descends along with some of the splenic tissue. There are two known types of this condition: the continuous form, where a band still connects the main spleen and the gonad, and the discontinuous form, where ectopic splenic tissue is attached to the gonad but has no connection to the orthotopic spleen. Around 200 cases have been reported in the literature so far. We present the case of a 4-year-old child who came with a bulge in the inguinoscrotal area. The family history was unremarkable. On clinical examination, the diagnosis of inguinal hernia was made, and he was scheduled for elective herniotomy. During surgery, a mass was found superior and indistinguishable from his left testicle. Laparoscopic exploration revealed a remnant of splenic tissue. A brown-like cord was seen inside the hernial sac connecting the intra-abdominal cavity with the upper pole of the left testicle. The segment was removed, and the remaining splenic tissue was repositioned into the abdominal cavity. The procedure went smoothly without complications. On the same day, a computed tomography scan showed no significant findings, and histopathological examination confirmed the mass to be splenic tissue. The postoperative course was smooth, and the patient was discharged the next day. This represents the 12 th case of SGF associated with a hernia, and the outcome in this case was successful with no intraoperative or postoperative complications.