Tc-99m Blood-Pool Imaging in Torsion of an Epididymal Appendix

Torsion of an epididymal appendix is one cause of acute hemiscrotum. The authors describe a 12-year-old boy who had two episodes of left scrotal pain within 10 days of hospital admission. Examination of the scrotum revealed a 3-mm dark spot on the skin overlying a tender nodule in the upper region on the left. A Tc-99m pertechnetate flow study and blood-pool images obtained 5 minutes later showed a linear hyperemic focus in the left upper hemiscrotum. Surgical exploration revealed torsion of a left epididymal appendix, which was removed and confirmed by histopathologic examination to be partially infarcted.