Torsion of Testicular Appendage – Hydatid Torsion
Definition
Torsion of Testicular Appendage is the rotation of the testicular appendix (hydatid of Morgagni) around its own axis with ischemia.
Signs and Symptoms of Hydatid Torsion
- Testicular pain
- Edema of the scrotum
- Blue dot sign: the hemorrhagic infarcted appendix testis can be seen through the scrotum
Diagnostic Work-Up
Laboratory Tests
- Urine analysis
- Complete blood count, CRP
Imaging
Doppler ultrasonography of the testis: signs for torsion of testicular appendage are a mild hydrocele, an enlarged testicular appendix [fig. ultrasonography of hydatid torsion ] and evidence of testicular blood flow. The problem is the reliable differentiation between testicular torsion and torsion of testicular appendage. If testicular torsion cannot be ruled out, surgical exploration is warrented.
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Ultrasonography of hydatid torsion: with hydrocele and a visible testicular appendix. By courtesy, Prof. Dr. R. Harzmann, Augsburg. |
Treatment of Hydatid torsion
In principle, the torsion of testicular appendage is treated conservatively with analgesics. In case of surgical exploration, the testicular appendage is removed after coagulation of the basis.
| Testicular torsion | Index | Varicocele |
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Deutsche Version: Hydatidentorsion
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Dr. med. Dirk Manski
man...@urologielehrbuch.de