Emergency operation in the true hermaphrodite

In two instances of undiagnosed true hermaphrodites, the patients presented with abdominal complaints requiring emergency operations. These patients, because of the abnormal location of the gonadal tissue, were considered to be at a higher risk for malignant degeneration or mechanical problems which may present in an acute state and, therefore, should be castrated. The presentation of either a male patient with hypospadias or cryptorchism, or both, or a female patient with genitalia ambiguity with an incarcerated inguinal hernia or abdominal pain should lead one to consider the diagnosis of true hermaphroditism. This is especially true if it occurs on the right side or if an abdominal mass is palpated. In these individuals, specimens of the contralateral gonad taken intraoperatively for biopsy and postoperative cytogenetic studies will aid in the diagnosis.