The Clinical Experience of Torsion of Testicular Appendix with Acute Scrotal Pain.
- Author:
Seok Won HONG
1
;
Hong Yong CHOI
Author Information
1. Department of Urology, Seoul Red Cross Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Torsion of testicular appendix;
Acute scrotal pain
- MeSH:
Appendix*;
Child;
Diagnosis;
Diagnosis, Differential;
Diagnostic Equipment;
Erythema;
Humans;
Inflammation;
Physical Examination;
Research Personnel;
Scrotum;
Spermatic Cord;
Spermatic Cord Torsion;
Testis;
Ultrasonography
- From:Korean Journal of Urology
1999;40(7):901-904
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Acute scrotal pain is one of the most alarming urologic symptoms, concealing testicular inflammation, testicular torsion, torsion of testicular appendix and a variety of miscellaneous diseases. Even with careful physical examination with recently developed diagnostic equipments, a reliable diagnosis may not be achieved in a significant number of patients. In these cases an operation is necessary for exclusion of testicular torsion. MATERIALS AND METHODS: Between 1991 and 1998, we reviewed 17 patients diagnosed as having torsion of testicular appenix, whose ages varied from 3 years to 15 years during recent 8 years. RESULTS: 16 cases out of seventeen patients(94%) were younger 12 years and prevalent age was 11 years(6/17). The average interval that elapsed from onset of symptoms until the patient was seen for the first time on the hospital was 64 hours, with a range varying from three hours to seven days. The most frequently observed symptoms and signs were diffuse scrotal pain, swelling and erythema of the affected scrotum. The explorative scrototomy were performed in 16 cases out of 17 patients who had appendix testis torsion, and the 1 case had conservative treatment after getting confirmative diagnosis by ultrasonography. The scrotal pain disappeared mostly within 1 day after operation, and the complications didn`t happen. CONCLUSIONS: There is controversy as whether the majority of children with torsion of the testicular appendix develop sufficiently grave symptoms to justify the surgical exploration. For this reason, once a diagnosis of torsion of the spermatic cord is ruled out, some investigators prefer conservative treatment. However, differential diagnosis with torsion of the spermatic cord is difficult and acute scrotal pain disappear within 24hours after excision of the twisted appendix. Therefore, we are in favor of surgical treatment.
