Torsion of scrotal contents in children

One hundred and forty consecutive cases of torsion of scrotal contents were reviewed retrospectively. There were 95 cases of torsion of the testicular appendage and 45 cases of testicular torsion. Testicular torsion was more common on the left and patients tended to present earlier with more systemic upset in the form of vomiting, abdominal and groin pain than patients with torsion of a testicular appendage. Pathognomic features of examination were an elevated or ectopic testis in 50% of cases of testicular torsion and a palpable tender blue nodule in 21% of cases of torsion of a testicular appendage. We believe that it is often possible to distinguish between these two conditions and, where this is possible, a trial of conservative management is justified for torsion of a testicular appendage.