Can We Distinguish Testicular Torsion From Torsion of the Appendix Testis in Children With Acute Scrotum? A Prospective Cohort Study

Acute scrotum is a urological emergency that needs prompt evaluation and management. The leading causes of acute scrotum in the pediatric population are testicular torsion (TT), torsion of the testicular appendix (TTA), trauma, epididymitis and orchitis [1]. While most TTA can be treated with cooling, analgesics and activity reduction, TT is a surgical emergency requiring prompt resumption of blood supply to the affected testis in order to save testicular tissue. The overlapping signs and symptoms of TT and TTA are usually a cause of difficulty and confusion, making it a real challenge for physicians to distinguish between these two conditions [2–5].