Torsion of Appendix of Testis - Masquerading as Acute Epididymitis

A case of torsion of the appendix of testis is described in a 11 years old boy. He presented with sudden onset of severe pain in the left testis of 2 hour duration. Emergency exploration of the left testis revealed a torsion appendix of the left testis. The appendix of the testis was excised and the wound was closed. The patient made a smooth post-operative recovery

The Clinical Significance of Torsion of Appendix Testis in Acute Scrotum / 대한비뇨기과학회지

The torsion of appendix testis is the second most common disease of the acute scrotal diseases in frequency. Despite recent development of diagnostic equipments, its differential diagnosis is often difficult and its treatment is controversial. We reviewed retrospectively 19 cases who were diagnosed to have torsion of appendix testis during recent 6 years. The mean age was 11.3 years. Five cases who had blue dot sign and tender mass on upper pole of testis, and one of 9 who had been examined with scrotal ultrasonography were diagnosed to have torsion of appendix testis, but other clinical finding and laboratory findings were not contributable to its diagnosis. Nine of 14 cases who were diagnosed by surgical exploration were consistent with the preoperative impression. Mean duration of scrotal pain were 1.3 days in surgical treatment group and were 3.6 days in conservative treatment group. The pathognomonic sign of torsion of appendix testis was seen only in a few cases. The diagnostic accuracy of torsion of appendix testis before exploration was low. The scrotal pain was relieved relatively more rapidly in surgical treatment group. So, we think that surgery was more desirable in diagnosis and treatment of torsion of appendix testis.

Torsion of the appendix testis: 3 cases / 대한비뇨기과학회지

Torsion of the appendix testis ranks second in causes of acute scrotal swelling in children Prompt surgical exploration in children with torsion of the appendix testis is necessary if scrotal swelling obscures diagnosis or induces persistent scrotal pain. Exploration of both testes at the first operation adds little trouble to the operation and eliminates the possibility of Further torsion.