In bell clapper deformity, the tunica vaginalis layer attachment to the spermatic cord is not fixed and it free. This can cause rotation or torsion of the testis.
Remember that the blood vessels to the testis come through the spermatic cord. So when there is torsion of testis due to bell clapper deformity, the spermatic cord gets twisted so the blood vessels and this causes the decrease or shut down of the blood supply to the testis. If this happens, the testis won't survive the lack of blood for much time and will die.
It is an surgical emergency and the testis has to be twisted again to put back in normal position.
Hope this helps... Thank you!!!
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