Torsion of a large appendix testis misdiagnosed as pyocele.

Susanta Meher,Tushar Subhadarshan Mishra,Rakesh Sharma,Prakash Kumar Sasmal,Satyajit Rath

doi:10.1155/2015/430871

Susanta Meher, Tushar Subhadarshan Mishra + Show 3 more

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https://doi.org/10.1155/2015/430871

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Abstract

Torsion of the appendix testis is not an uncommon cause of acute hemiscrotum. It is frequently misdiagnosed as acute epididymitis, orchitis, or torsion of testis. Though conservative management is the treatment of choice for this condition, prompt surgical intervention is warranted when testicular torsion is suspected. We report a case of torsion of a large appendix testis misdiagnosed as pyocele. Emergency exploration of it revealed a large appendix testis with torsion and early features of gangrene. After excision of the appendix testis, the wound was closed with an open drain. The patient had an uneventful and smooth postoperative recovery.

Highlights

Torsion of the appendix testis is a common cause of scrotal pain in children
It is a common cause of acute scrotal pain in children and is frequently misdiagnosed as acute epididymitis, epididymoorchitis, or torsion of testis
In a study by Knight and Vassy [5] of acute scrotal pain in 395 boys ranging in age from 30 days to 17 years, the frequencies of diagnoses were testicular torsion (38%), epididymitis or orchitis (31%), and torsion appendix testis (24%)

Summary

Introduction

Torsion of the appendix testis is a common cause of scrotal pain in children. It occurs during the prepubertal years (ages 7–14), often precipitated by trauma or exercise [1]. Most of the cases present with unilateral pain and swelling of the scrotum and are frequently misdiagnosed as torsion of testis, epididymitis, or epididymoorchitis. Misdiagnosis of pyocele against torsion of a large appendix testis is an extremely rare event

Case Report

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