Testicular appendage torsion

This is torsion of a remnant piece of tissue attached to the testicle which can torsion on it’s pedicle, and may be seen as a small blue dot on examination. It has no function so can be treated conservatively with analgesia. However, if there is significant pain or generalised swelling then it would be safer to treat as testicular torsion. Additionally, in those with significant pain, exploration and surgical management may provide symptom resolution and return to normal function more rapidly than conservative management.

Learning Bite

diagnosis of torsion is a clinical one and surgical exploration of the scrotum is the investigation of choice, allowing the treatment of detorsion and orchidoplexy to occur. Time is testicle!