Excision of recurrent appendix testis torsion

A 6-year-old boy developed left side scrotal pain. We diagnosed the patient as having left appendix testis torsion. We prescribed acetaminophen and the pain gradually improved. Four months after the initial episode of pain, the patient had scrotum pain again. Ultrasonography revealed a swollen appendage at the upper pole of the testis with calcification. We performed resection of the twisted appendix testis. Pathological examination revealed lymphocytic infiltration, fibrosis, edema, granulation tissue, and frequent foci of calcification. There was no necrosis. Some cases of appendix testis torsion whose initial symptoms are conservatively managed, require subsequent removal of the chronically inflamed appendage accompanied by acute inflammation for persistent or recurrent pain several months after appearance and resolution of the initial symptoms. Keywords: Acute scrotum, Torsion of appendix testis, Recurrence symptoms