Testicular torsion is a surgical emergency. Which statement regarding the Bell-Clapper deformity is most accurate?
- A It results from a high investment of tunica vaginalis that envelops the testis and epididymis, allowing free intravaginal rotation ✓
- B It refers to a high attachment of the tunica vaginalis to the epididymis, preventing rotation
- C It is an acquired deformity following orchitis
- D It is present only in undescended testes
Correct answer: A. It results from a high investment of tunica vaginalis that envelops the testis and epididymis, allowing free intravaginal rotation
Explanation
Bell-Clapper deformity is a congenital anomaly in which the tunica vaginalis has an abnormally high attachment on the spermatic cord, allowing the testis and epididymis to hang freely within the scrotal sac like a bell clapper. This allows intravaginal torsion to occur. It is bilateral in 70% of cases, which mandates contralateral orchidopexy at the time of surgery for unilateral torsion. It is unrelated to cryptorchidism (extravaginal torsion occurs in neonates regardless of descent).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.