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KMID : 1103720130690020157
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Journal of the Korean Society of Radiology
2013 Volume.69 No. 2 p.157 ~ p.163
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Ultrasonographic Findings of Torsed Testicular Appendages in Prepubertal Children
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Shin Su-Mi
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Abstract
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Purpose: To characterize the sonographic findings of torsed testicular appendages and to evaluate the sonographic findings in making erroneous diagnosis of epididymitis or torsion of testis in prepubertal children. Materials and Methods: From June 2010 to November 2012, we retrospectively analyzed the duplex sonography of fifteen children with torsion of testicular appendages. The presence or absence of the extratesticular nodule and secondary inflammatory changes were evaluated. Six patients had follow-up sonography and two patients underwent surgery. Results: Sonography demonstrated the extratesticular nodule in 13 (87%) children. Four of these 13 children were misdiagnosed as epididymitis due to imperceptions of the nodule. Out of remaining two (13%) children without the nodule, one mimicked epididymitis and the other was misdiagnosed as torsion of testis. Secondary inflammatory changes included enlarged epididymis in 14 children (93%), scrotal wall edema in 11 (73%), hydrocele in 10 (67%), and enlarged testis in 3 (20%). Conclusion: Ultrasonographic findings of secondary inflammatory changes in the absence or imperception of the nodules for epididymo-testicular groove or epididymal head may suggest an erroneous diagnosis of epididymitis or torsion of testis in children with torsed testicular appendages. Meticulous evaluation for the nodule is important when differentiating the torsed testicular appendages from the two entities of prepubertal children.
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KEYWORD
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Torsion of Testicular Appendage, Acute Scrotum, Epididymitis, Torsion of Testis, Ultrasonography
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