Appendix Epididymis  (Torsion of the Appendix Testis)

What is torsion of the appendix testis or appendix epididymis?

The appendix testis is a small structure often found above the testis. The appendix epididymis is a small structure located at the head of the epididymis. These appendages can twist causing scrotal pain. Unlike a testicular torsion, this is not an emergency. Torsion of the appendix testis or appendix epididymis occurs most often in boys around 7 to 12 years of age.

What are the signs and symptoms of torsion of the appendix testis/epididymis?

The most common sign is sudden pain in the scrotum. Swelling of the scrotum may occur. Blood flow to the testicle is not affected. It is very important to seek urgent medical care in the presence of testicular or scrotal pain to rule our true testicular torsion. While torsion of the appendix testis and epididymis is not an emergency, true testicular torsion is. It can be difficult to determine the difference between these conditions without experience healthcare provider assessment.

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

The diagnosis can be made clinically by physical examination of the scrotum. Often a scrotal ultrasound will be performed to rule out true testicular torsion. With torsion of the appendix testis and appendix epididymis, blood flow the testicles is present. In true testicular torsion, it is not. Testicular ultrasound can sometimes show the twisted appendage.

How is torsion of appendix testis or appendix epididymis treated?

The treatment of a torsed appendix testis or appendix epididymis is based on supportive care. Often, analgesics, bed rest, and scrotal support will improve symptoms. Pain can last 3 to 10 days.

The Division of Urology at Arkansas Children’s is experienced in diagnosing and treating scrotal pain and will work with you to determine a diagnosis and treatment plan for your child.