Appendix Testes Torsion

Torsion of the testicular appendages is considered to be the most common cause of acute scrotal pain in prepubertal children and may even be the single most prevalent cause of pediatric orchalgia. [1] It should, therefore, be included in the differential for any male presenting with an acute scrotum but especially in the pediatric age group.[1] There are two testicular appendages that can twist and become symptomatic: the appendix testis and the appendix epididymis. The appendix testis, sometimes called hydatid of Morgagni, is a vestigial remnant of the Mullerian duct and is present in 76% to 83% of testes.[2] When present, it is located on the superior pole of the testicle between the testis and epididymis and is the most common testicular appendage to undergo torsion. It is homologous to the fimbriated end of the Fallopian tube in the female. The appendix epididymis is a vestigial Wolffian (mesonephric) duct remnant and is present in 22% to 28% of the testes.[2] When present, it occurs along the head of the epididymis. It is sometimes considered to be a detached efferent epididymal duct.