A double whammy - epididymal torsion in an undescended testis: A case report

Isolated epididymal torsion is a very rare cause of an acute scrotum. Anomalies of the epididymis are more commonly encountered with undescended testicles and can predispose to epididymal torsion. Management is similar to that of testicular torsion. We report the case of a 3-year-old boy who presented with an acute scrotum. Immediate surgical exploration revealed an isolated epididymal torsion in an undescended testis, only the second of its kind to be reported so far. The epididymis and testis were salvaged and the testis was fixed in the scrotum. There are multiple learning points from this case report. Firstly, that epididymal torsion is a diagnosis to be considered when exploring an acute scrotum. Secondly, that epididymal torsion even an undescended testis can result in clinical symptoms of an acute scrotum. And finally, that epididymal anomalies encountered during surgery should be tackled appropriately, to prevent retorsion.