Differential Diagnosis for Big Testes in a Newborn
- Single Most Likely Diagnosis
- Congenital hydrocele: This condition is characterized by the accumulation of fluid around a testicle, causing the scrotum to swell. It is a common cause of enlarged testes in newborns and is often benign, resolving on its own within the first year of life.
- Other Likely Diagnoses
- Hernia: An inguinal hernia can cause the testes to appear enlarged due to the protrusion of intestinal contents into the scrotum. This condition is more common in premature infants.
- Testicular torsion: Although less common in newborns, testicular torsion can cause sudden swelling and pain. However, it's more of an emergency and would typically present with additional symptoms such as pain and discoloration.
- Epididymitis: Inflammation of the epididymis, which can be caused by infection, can lead to swelling of the testes. However, this is less common in newborns.
- Do Not Miss Diagnoses
- Testicular tumor: Although rare, testicular tumors can present as enlarged testes in newborns. Given the potential severity of this condition, it's crucial not to miss it.
- Trauma: Physical trauma to the testes can cause swelling and should be considered, especially if there's a history of difficult delivery or other forms of injury.
- Rare Diagnoses
- Polyorchidism: A rare congenital anomaly where a person has more than two testes. This condition can present with enlarged testes due to the presence of extra testicular tissue.
- Splenogonadal fusion: A rare condition where there's an abnormal connection between the spleen and the gonads, which can lead to testicular enlargement.
- Testicular cysts: Benign cysts within the testes can cause enlargement, though this is less common in newborns.