Torsion of testicular appendage: Difference between revisions
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''Not to be confused with [[Testicular Torsion]]'' | |||
==Background== | ==Background== | ||
[[File:Gray1144.png|thumb|Scrotal anatomy]] | |||
[[File:Figure 28 01 03.jpg|thumb|Testicular anatomy]] | |||
*Appendix testis and appendix epididymis can torse | *Appendix testis and appendix epididymis can torse | ||
**Most common between 7- | **Most common between 7-14yr | ||
**No affect on fertility or surrounding structures | **No affect on fertility or surrounding structures | ||
== | ==Clinical Features== | ||
*Scrotal pain | *[[testicular Pain|Scrotal pain]] | ||
**Milder and more gradual onset compared to testicular torsion | **Milder and more gradual onset compared to testicular torsion | ||
**Localized to one point of testicle | **Localized to one point of testicle | ||
| Line 11: | Line 14: | ||
**Hard, tender 2-3mm nodule at upper pole of testicle | **Hard, tender 2-3mm nodule at upper pole of testicle | ||
**Transillumination: ischemic appendage appears as blue dot (highly sp, not sn) | **Transillumination: ischemic appendage appears as blue dot (highly sp, not sn) | ||
==Work-Up== | ==Differential Diagnosis== | ||
* | {{Testicular DDX}} | ||
* | |||
==Evaluation== | |||
===Work-Up=== | |||
*[[Urinalysis]] | |||
*[[testicular ultrasound|Ultrasound]] | |||
== | ===Evaluation=== | ||
*[[testicular torsion|Ultrasound]] | |||
**Normal testicular flow, small hyperechoic region adjacent to testis | |||
== | ==Management== | ||
#Scrotal elevation | #Scrotal elevation | ||
#Ice | #Ice | ||
#NSAIDS | #[[NSAIDS]] | ||
==Disposition== | ==Disposition== | ||
*Discharge | |||
*Symptoms resolve in 7-10 days | |||
==See Also== | ==See Also== | ||
[[Testicular Torsion]] | *[[Testicular Torsion]] | ||
*[[Testicular Diagnoses]] | |||
[[Category: | ==References== | ||
[[Category: | <references/> | ||
[[Category:Urology]] | |||
[[Category:Pediatrics]] | |||
Latest revision as of 20:15, 4 June 2020
Not to be confused with Testicular Torsion
Background
- Appendix testis and appendix epididymis can torse
- Most common between 7-14yr
- No affect on fertility or surrounding structures
Clinical Features
- Scrotal pain
- Milder and more gradual onset compared to testicular torsion
- Localized to one point of testicle
- Physical exam
- Hard, tender 2-3mm nodule at upper pole of testicle
- Transillumination: ischemic appendage appears as blue dot (highly sp, not sn)
Differential Diagnosis
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Evaluation
Work-Up
Evaluation
- Ultrasound
- Normal testicular flow, small hyperechoic region adjacent to testis
Management
- Scrotal elevation
- Ice
- NSAIDS
Disposition
- Discharge
- Symptoms resolve in 7-10 days