Torsion of a testicular appendage, although benign, is painful and must be distinguished from testicular torsion, a true urologic emergency. The vestigial tissues forming the appendices commonly are pedunculated and structurally are predisposed to torsion. Torsion of an appendage leads to ischemia and infarction. Torsion of the testicular appendage also may be accompanied by presence of a thickened scrotal wall, hydrocele, and enlargement of the head of the epididymis. Torsion of the testicular appendices is virtually a benign condition.
Necrotic tissue is reabsorbed without any sequelae in almost all cases.
The literature contains only one case report of a scrotal abscess secondary to tissue necrosis. Little evidence supports the suggestion that scrotal calculi can form because of calcification of the necrotic appendix. No racial or ethnic predilection exists. Mean age is 10.6 years. Torsion of testicular appendices is the leading cause of acute scrotum in children.