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Epididymal Appendageal Torsion
Case Detail
| Anatomy: Genitourinary |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Vascular |
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| Created: 11 months ago |
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| Updated: 11 months ago |
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| Tags:
PEDS
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| Modality/Study Types:
US
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Activities:  PDF  ImageJA |
History
Teenager with acute scrotal pain.
Case Images
Diagnosis
Epididymal Appendageal Torsion
Findings
US – Enlarged avascular epididymal appendage with microcystic change.
Discussion
Torsion of the appendix of the epididymus is a common cause of acute scrotum in children. The appendix epididymidis is a remnant of the mesonephric duct (the appendix testis is a remnant of the paramesonephric duct). The appendix epididymidis is present in 20% of pediatric males. The appendix epididymidis is visualized at sonography as an isoechoic stalked structure projecting from the head of the epididymis (the appendix testis is an ovoid isoechoic structure located in the groove between the testis and the head of the epididymis). Torsion of the epididymal appendix can be diagnosed when is measures >5.6 mm or is avascular on Doppler; epididymal appendix torsion may also be associated with hyperemia of the adjacent epididymus and hydrocele.
Reference
Baldisserotto M, Ketzer de Souza JC, Pertence AP, et al.Color Doppler Sonography of Normal and Torsed Testicular
Appendages in Children. AJR (2005);184:1287–1292.
Contributor
Linda Woolpert, RDMS