Urology Book


Torsion of Testicular Appendage

Aka: Torsion of Testicular Appendage, Torsion of Appendix Testes
  1. Epidemiology
    1. Most common in boys under age 3-5 years up to age 12 years old
  2. Differential Diagnosis
    1. Testicular Torsion
    2. Epididymitis
  3. Symptoms
    1. Insidious or sudden onset of unilateral Scrotal Pain
      1. Less severe pain than with Testicular Torsion
    2. Similar characteristics of Testicular Torsion without the systemic symptoms (e.g. rare Nausea or Vomiting)
  4. Signs
    1. Tiny, focally tender, palpable mass at Testis upper pole
    2. "Blue dot" sign on scrotal skin early in course
    3. Testicular Inflammation and Hydrocele are late findings
  5. Differential Diagnosis
    1. See Testicular Torsion
    2. See Testicular Pain
  6. Imaging
    1. Ultrasound
      1. Critical to distinguish from Testicular Torsion
  7. Course
    1. Pain resolves in 5-10 days (up to 14 days)
  8. Precaution
    1. Difficult to distinguish from Testicular Torsion
  9. Management
    1. Urology referral indications
      1. Presentation too late to make accurate diagnosis
      2. Unable to rule-out Testicular Torsion
      3. Urologists may resect appendix Testes in cases of persistent discomfort
    2. Scrotal support (e.g. tight underwear or jock strap)
    3. NSAIDs
  10. References
    1. Lewis (1995) J Pediatr Surg 30:277-82 [PubMed]
    2. Hawtrey (1998) Urol Clin North Am 25:715-23 [PubMed]
    3. Ringdahl (2006) Am Fam Physician 74:1739-46 [PubMed]
    4. Sharp (2013) Am Fam Physician 88(12): 835-40 [PubMed]

Torsion of appendix of testis (C0392531)

Concepts Anatomical Abnormality (T190) , Disease or Syndrome (T047)
ICD9 608.23
ICD10 N83.52, N44.03
SnomedCT 198047009
English Torsion of hydatid of Morgagni - male, Torsion hydatid Morgani - male, Torsion of hydatid of Morgani - male, Torsion of appendix of testis, torsion of appendix testis, torsion of appendix testis (diagnosis), testicle torsion appendix, Torsion appendix testis, Torsion of hydatid of Morgagni, Torsion of appendix testis, appendix testis torsion, torsion appendix testis, Torsion of appendix of testis (disorder), hydatid; Morgagni, torsion male, Hydatid of Morgagni torsion
Spanish torsión de apéndice testicular (trastorno), torsión de hidátide de Morgani en el hombre, torsión de apéndice testicular, torsión de hidátide de Morgani en el hombre (trastorno)
Dutch hydatide; Morgagni, torsie man
Derived from the NIH UMLS (Unified Medical Language System)

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