Which anatomical predisposition can contribute to torsion?

• A. Bell clapper deformity
• B. Hydrocele
• C. Epididymal cyst
• D. Inguinal hernia

Answer: (A)

Torsion occurs when the testis twists around the spermatic cord, cutting off its blood supply. The anatomical predisposition that makes this more likely is a Bell clapper deformity, where the testis is inadequately tethered within the scrotum due to excessive mobility of the tunica vaginalis. With this mobility, the entire testis can swing and rotate, allowing twisting of the vascular pedicle. This congenital setup is why torsion can occur even without any external trigger and is especially a risk during puberty when rapid growth and activity can provoke twisting. The other conditions—fluid around the testicle (hydrocele), a cyst from the epididymis, or a protruding abdominal contents (inguinal hernia)—do not create the same testicular mobility that predisposes to twisting.