Torsion of the Epididymal Appendage in a Child

The epididymal appendage, or the appendix epididymis, is a developmental remnant of the mesonephric duct that sprouts from the head of the epididymis. Due to its pedunculated anatomical configuration, the epididymal appendage is prone to torsion and can become a rare cause of an acute scrotum. Given its often challenging and atypical presentation, high clinical suspicion and Doppler ultrasonography are needed to guide diagnosis. We report a challenging case of epididymal appendage torsion that required prompt surgical exploration to accurately diagnose. Awareness of this condition and its radiological findings can play an important role in reaching an accurate diagnosis and avoiding surgical intervention.