Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

Little attention has been given to the sonographic appearances of the epididymis in testicular torsion. To describe the position and morphology of the epididymis in childhood acute testicular torsion when testicular flow is present on color Doppler sonography. We studied the sonographic findings in boys with clinically and surgically proven acute testicular torsion who were examined sonographically from May 2013 to May 2014 and who had preserved intratesticular flow on color Doppler sonography. We retrospectively evaluated the sonograms with emphasis on the epididymal findings. In all nine boys with confirmed torsion but with preserved intratesticular flow on color Doppler sonography, the epididymal head had an unexpected configuration and size, and no close relationship with the upper pole of the testis. In five of these children the spermatic cord appeared twisted on the affected side. In the remaining four boys the spermatic cord appeared straight. The position and morphology of the head of the epididymis were abnormal in all boys with acute testicular torsion but with preserved testicular flow.