RESUMO
This is a case report of extravaginal twisting of the spermatic cord in a neonate (third pregnancy, without prenatal care, obtained through iterative cesarean section), which occurred during the prenatal (in uterus) period since it was present at birth. Clinically found were: an enlargement of the right hemiscrotum, color changes (violet), induration, absence of the cremasteric reflex and no translumination. Ultrasonography showed homogeneous opaqueness of the right scrotal pouch. Right radical orchiectomy was carried out after finding testicular necrosis. The differential diagnosis includes: tumor, hematocele, testicular twist of the epidydimus appendexes, incarcerated hernia, scrotal abscess, supradrenal gland or ectopic spleen and the twisting of the spermatic cord. All of these conditions require immediate surgical exploration through the inguinal region in order to obtain a correct diagnosis and give prompt treatment. If there is twisting, contralateral fixation is necessary.