ABSTRACT
Introduction: Torsion of the appendix of the epididymis is a rare cause of acute scrotum. However, it can be distinguished from testicular torsion by its insidious onset and localizable tenderness. In addition, colour Doppler ultrasonography has characteristic findings in torsion of the testicular appendage.
Case presentation: We present a case of a 9-year-old male presenting with sudden onset left hemi-scrotal pain, and had clinical features mimicking testicular torsion with consequent immediate scrotal exploration. Intra-operative finding was in keeping with torsion of the epididymal appendage as against the earlier clinical presentation suggestive of testicular torsion.
Conclusion: Acute scrotum being a time dependent emergency may in some circumstance not allow time for Doppler ultrasonography which will differentiate torsion of epididymal appendix from testicular torsion, and thus preventing unnecessary scrotal exploration.