Torsion of testicular appendage

Background

• Appendix testis and appendix epididymis can torse
  • Most common between 7-14 years old
  • No affect on fertility or surrounding structures

Diagnosis

• 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)
• Ultrasound
  • Normal testicular flow, small hyperechoic region adjacent to testis

Work-Up

• UA
• Ultrasond

DDx

1. Testicular torsion
2. Testicular mass
3. Epididymitis

Treatment

1. Scrotal elevation
2. Ice
3. NSAIDS

Disposition

1. Discharge
2. Symptoms resolve in 7-10 days

See Also

Testicular Torsion

Source

Tintinalli, Rosen's