Torsion of the appendix testis and appendix epididymis

Torsion of the appendix testis and appendix epididymis

The appendix testis (hydatid of Morgagni) is a remnant of the Müllerian (paramesonephric) duct, whereas the appendix epididymis is a Wol ffi an (mesonephric) remnant. Both are Giovanni Battista Morgagni , 1682–1771, Italian anatomist, considered the father of modern anatomical pathology . Johannes Peter Müller , 1801–1858, German physiologist, comparative anatomist, ichthyologist and herpetologist. Caspar Friedrich Wol ff , 1733–1794, German physiologist and one of the founders of embryology . - small and pedunculated and are located on the upper testis or epididymis; they can twist and infarct ( Figure 17.7 ). Append - age torsion occurs most commonly between 7 and 14 years. Mild to severe acute scrotal pain is present, usually without vomiting. On examination, a small area just above the testis may be tender; occasionally , a dark mass is visible , known as tion the blue-dot sign. A Doppler ultrasound can help exclude testicular torsion. Analgesia, and rest, may be su ffi cient, with exploration reserved for severe pain and equivocal cases. -

Figure 17.5 The red and blue colour on one testis shows normal blood /f_l ow whereas the contralateral testis has no blood supply, consistent with a torsion. Figure 17.6 Torsion of the right testis with only modest vascular compromise in a boy with a history of intermittent pain.