Torsion of testicular appendage

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

Evaluation

Work-Up

Evaluation

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

Management

  1. Scrotal elevation
  2. Ice
  3. NSAIDS

Disposition

  • Discharge
  • Symptoms resolve in 7-10 days

See Also

References