Isolated torsion of appendix epididymis–a difficult diagnosis

Abstract

An 8-year-old male patient complaining of pain in the left scrotum for four hours. Relatives deny comorbidities. The patient denies trauma or recent sports. On clinical examination, there is a small blue dot in the painful scrotum. Ultrasound shows preserved testicles, discarding testicular torsion, and a hypoechoic, oval, well-defined image, adjacent to the head of the left epididymis, measuring 6.5 mm, compatible with appendix epididymis torsion (Figure 1). The patient was conducted to conservative treatment-rest and analgesics, with resolution in one week.

Torsion of the Epididymal Appendage in a Child

“…As such, management is mainly focused on pain management with nonsteroidal anti-inflammatory drugs (NSAIDs), ice packs, and scrotal elevation. Nevertheless, surgical intervention through appendage excision can shorten the average duration of symptoms [ 1 , 4 ].…”