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 1 case report of a scrotal abscess secondary to tissue necrosis. Little evidence supports the suggestion that scrotal calculi can form due to calcification of the necrotic appendix. Occurrence does not change with race or ethnicity. Mean age is 10.6 years. Patient history is important to distinguish torsion of the testicular appendages from testicular torsion and other causes of acute scrotum.