Torsion of testicular appendage: Difference between revisions
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Revision as of 17:01, 22 March 2016
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
Diagnosis
Work-Up
- UA
- Ultrasound
Evaluation
- Ultrasound
- Normal testicular flow, small hyperechoic region adjacent to testis
Treatment
- Scrotal elevation
- Ice
- NSAIDS
Disposition
- Discharge
- Symptoms resolve in 7-10 days