Fig. 21

Torsion of the appendix testis. A 9-year-old boy who presented to ER with left-sided scrotal pain which started 3 days before presentation. Physical examination revealed left testicular tenderness and a small, firm scrotal mass. a Gray scale US image shows a round mildly heterogeneous solid-appearing extratesticular lesion adjacent to the upper pole of left testis (arrowheads). Minimal hydrocele and scrotal wall thickening were also noticed on US. b Color flow Doppler US shows the absence of vascularity within the lesion (asterisk). As clinical history was more suggestive for torsion of the appendix testis, the patient was placed on supportive treatment. He responded well to treatment, and his symptoms completely resolved within a week