Heterochronic occurrence of bilateral torsion of appendix testis a case report

Abstract

An 8-year-old boy who had undergone excision of the left appendix testis for torsion of the left appendix testis about one and a half years previously was brought to our department on February 18, 1991 because of right scrotal pain of 4 days' duration. Palpation revealed induration with tenderness of the superior portion of the right testicle. A scrotal ultrasonographic tomogram revealed a shadow probably representing an enlarged appendix testis. The patient was diagnosed as having torsion of the right appendix testis. There was refractory pain, and there was possibility of reactive epididymitis. So the patient underwent excision of the right appendix testis, two right appendices testis, which had enlarged to 5 mm in diameter were found, histopathological examination revealed slight bleeding and marked edema of the stroma, which may have been caused by torsion of the appendix testis. Scrotal pain subsided postoperatively. Bilateral torsion of the appendix testis is very uncommon, and our case is the 14th case reported. Torsion of the appendix testis occasionally develops. Torsion of the appendix testis occasionally develops bilaterally. When a small, tender mass at the superior pole of testis, torsion of the appendix testis should be considered.