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Torsion of Appendix Testis

Homepage: EMNote.org ■ 🚩Membership: https://tinyurl.com/joinemnote 🚩ACLS Lecture: https://tinyurl.com/emnoteacls Torsion of Appendix Testis: Appendix Testis Overview • Appendix testis is a small, benign tissue in the upper part of the testes. • It's a remnant of the Müllerian duct, present in about 80% of males. • The appendix testis has no known function. Also called the testicular appendix or hydatid of Morgagni. Pathophysiology of Appendix Testis Torsion • Torsion is a common cause of acute scrotal pain in children aged 7-12. • Exact cause is unclear, but may relate to trauma or pubertal changes. • Cold temperatures might contribute to increased torsion cases. Clinical Manifestations • Sudden onset of pain localized to the upper pole of testis or epididymis. • Pain is typically less severe than testicular torsion with gradual onset. • A palpable, localized mass may be present in the area of tenderness. • "Blue dot sign" may be visible on the scrotum in some cases. Diagnosis • Diagnosis primarily relies on thorough history and physical examination. • Color Doppler ultrasonography is the preferred imaging modality. • Ultrasound can reveal normal testicular blood flow and torsed appendage. • Radionuclide imaging can detect a "hot dot" sign but is less preferred. Management • Most cases resolve with conservative management. • Treatment includes rest, scrotal elevation, ice application, and pain relief. • Surgery is rarely indicated, mainly for diagnostic uncertainty or severe pain. Prognosis • Prognosis for appendix testis torsion is excellent. • Loss of appendix testis has no long-term consequences. • Conservative treatment is usually successful without complications. • Main concern is potential misdiagnosis of testicular torsion.