Torsion of testicular appendage: Difference between revisions
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''Not to be confused with [[Testicular Torsion]]'' | |||
==Background== | ==Background== | ||
*Appendix testis and appendix epididymis can torse | *Appendix testis and appendix epididymis can torse | ||
**Most common between 7-14yr | **Most common between 7-14yr | ||
**No affect on fertility or surrounding structures | **No affect on fertility or surrounding structures | ||
== | ==Clinical Features== | ||
*Scrotal pain | *Scrotal pain | ||
**Milder and more gradual onset compared to testicular torsion | **Milder and more gradual onset compared to testicular torsion | ||
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**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}} | |||
==Diagnosis== | |||
===Work-Up=== | |||
*UA | *UA | ||
* | *Ultrasound | ||
== | ===Evaluation=== | ||
*Ultrasound | |||
**Normal testicular flow, small hyperechoic region adjacent to testis | |||
==Treatment== | ==Treatment== | ||
#Scrotal elevation | #Scrotal elevation | ||
#Ice | #Ice | ||
#NSAIDS | #[[NSAIDS]] | ||
==Disposition== | ==Disposition== | ||
*Discharge | |||
*Symptoms resolve in 7-10 days | |||
==See Also== | ==See Also== | ||
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*[[Testicular Diagnoses]] | *[[Testicular Diagnoses]] | ||
== | ==References== | ||
[[Category:GU]] | [[Category:GU]] | ||
[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 10:53, 1 August 2015
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