Renal & Urology/ Torsion of Appendix Tests or Appendix Epididymis

Question 1

What is the appendix testis?

Answer 1

A vestigial structure located on the anterosuperior aspect of the testis (present in 90%)

Question 2

What is the appendix epididymis?

Answer 2

A vestigial structure located at the head of the epididymis (present in 23%)

Question 3

Which patients are typically affected by torsion of appendix testis and appendix epididymis?

Answer 3

7-12 year olds

Question 4

What signs and symptoms are seen with torsion of these structures?

Answer 4

• Sudden onset of scrotal pain (typically less intense than testicular torsion)
• tender localized testicular or epididymal mass
• blue dot sign (the appendix has become gangrenous)
• normal cremasteric reflex

Question 5

How is the torsion of appendix testis or appendix epdidymis diagnosed?

Answer 5

• Can be diagnosed clinically
• Doppler ultrasound can be used when testicular torsion cannot be excluded

Question 6

How is tosion of appedix testis/ appedix epididmys managed?

Answer 6

• analgesics
• scrotal support
• reassurance (symptoms resolve in 5-10 days)
• surgery for patients with persistent pain