In spite of today's striking development of radiologic studies, the differential diagnosis of acute scrotal diseases is difficult. we studied 14 cases of appendix testis torsion that had visited cur hostital from May 1991 to October 1994 in order
to be
diagnosed acurately and made appropriate treatment. The torsion of appendix testis occurred during prepubertal ages, and ages of our 14 cases were from 3 to 13, and average age was 9.6 years old. In all of our cases the chief complaint was
scrotal
pain.
The lcoalized palpable tender mass of testicular upper pole were present in only 8 of 14 cases and 5 cases had blue dot sign. These were very helpful in diagnosis of torsion of appendix testis. Doppler ultrasonography was done in 9 cases and
radionuclide scrotal imaging was done in 3 cases, but none of these studies were diagnosed as torsion of appendix testis definitely. But in 8 cases that had positive blue dot sign and/or localizing tender mass in upper pole of testis, we could
diagnose
torsion of appendix testis certainly. We operated 11 of 14 cases (scrotal exploration and excision of torsed appendix testis) and treted coservatively 3 of 14. Most 11 operated cases were revealed that scrotal pains were relieved within 24 hours
of
postoperative period and secondary complications did not occurred in 3 cases treated conservatively.
In summary, the early surgical exploration is necessary to improve maximal testitcular salvage when testis torsion cannot be ruled out completely in acute scrotal diseases. But if testis torsion can be ruled out completely, conservative
treatment
may
be considered in torsion of appendix testis.
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