The testicular appendage is a remnant of the degenerated upper end of the Mullerian duct. It is located above the testis and is a small ovoid body with a tip, often attached to the white membrane of the testis. Torsion of the testicular appendage is most often seen in children. The attachment of the epididymis, on the other hand, is a remnant of the nootropic duct. The onset of the disease is usually mild and gradually worsens over a day or two; however, there are cases of severe pain and acute attacks. It presents as a sudden onset of pain in the scrotum. It is usually a dull pain, but can also be colic. The degree of pain varies. The pain may radiate to the lower abdomen. It may be accompanied by nausea, vomiting and other systemic symptoms. A lump may be detected above the testicle with mild pressure pain. A small amount of reactive syringomyelia may be detected. If necrosis occurs, a transillumination test reveals a blue color of the effusion and an attachment may be palpated above the testis. The position of the testis and spermatic cord is normal. The diseases that need to be differentiated from testicular adnexal torsion are approximately the same as testicular torsion and the main points to be noted are as follows. Testicular torsion often has a history of strenuous exercise and injury to the scrotum and is associated with severe nausea, vomiting, and severe pain in the scrotum. The testicle is seen to move upward during the examination, and moving the testicle can make the pain worse. Doppler ultrasonography shows no blood in the testicles. Acute epididymitis is an acute inflammation of the epididymis with rapid onset and may be accompanied by severe systemic symptoms, such as fever and elevated white blood cell count. On examination, the scrotum is obviously enlarged and the skin is red; the epididymis is obviously enlarged and the boundary with the testis is indistinguishable. Tenderness is obvious. The history of unclean sexual intercourse and transurethral instrumentation can be inquired about in general. Treatment: If the diagnosis is not clear, spermatic torsion should be excluded and surgical investigation should be performed if necessary. The symptoms can be relieved by holding up the scrotum, bed rest, and oral non-hormonal anti-inflammatory drugs.