Laiba Masood, Mahad Umer Lodhi, Muhammad Usman, Umar Riaz


Acute scrotum due to acute pain and swelling in the scrotal region is common in the emergency department in male children and adolescents. An epididymal appendage or appendix testes is a pedunculated vestigial remnant of the mesonephric duct attached to the epididymal head, prone to torsion and may present mimicking testicular torsion. However, high clinical suspicion and doppler ultrasound may aid in forming a diagnosis, buying surgeons time which in cases of testicular torsion is imperative to salvage the involved testes. We present a case of a 12-year-old boy with a history of trauma to the left testicle with grey-scale and Doppler ultrasound imaging features that formulated the torsion of appendix testes, confirmed on surgical exploration.

In the prepubertal age group, torsion of testicular appendage represents an important cause of the urological emergency. Therefore, especially in post-traumatic cases, this should be kept in differential diagnosis and ruled out by appropriate imaging modality to start prompt treatment.

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