Torsion of Testicular Appendix
Torsion of an appendix testis and appendix epididymis are common causes of torsion. Both of these are small tags of normal tissue attached to the testicle. Occasionally, examination of the scrotum reveals what looks like a small “blue dot.” This is the swollen, dying appendage of the testicle. Characteristically a firm, tender nodule can be felt next to the testicle. The nodule can be moved within the scrotum, and the testis itself is normal. Patients who present after torsion of the appendix testis may have these characteristic findings obscured by the presence of swelling in the testicle.
Treatment generally consists of bed rest, analgesia, and reassurance. Because torsion of the appendix testis may precipitate reactive epididymitis, prophylactic antibiotics may be helpful in selected patients. Patients in whom testicular torsion cannot be excluded or who have resistant incapacitating pain require scrotal exploration and excision of the involved appendage. Prognosis is excellent.
Article and graphics adapted from O'Neill: Principles of Pediatric Surgery. © 2003, Elsevier.